摘要
目的 评价双源CT对颌面部脉管 性疾病的的诊断价值。方法 回顾性分析 24例颌面部脉管性疾病患者的双源CT影像 资料,原始数据应用MIP、MPR、VR及双能 去骨后处理技术,其中13例儿童受检者使 用虚拟平扫技术获得平扫图像。结果 24 例颌面部脉管性疾病患者中,18例为血管 瘤,分别发生在腮腺咬肌区6例,颊部3 例,眶部2例,耳前2例,鼻部2例,唇部3 例,CT平扫表现为皮下类圆形软组织密度 肿块,其中3例可见静脉石,15例增强后 可见持续不同程度明显强化,3例强化不 明显或轻度强化;6例为血管畸形,表现 为病变部位不规则明显强化异常血管团, MPR、VR可见迂曲增粗的供血动脉、引流 静脉及侧支。结论 双源CT去骨技术及后 处理技术可以清楚显示颌面部病变及异常 血管的细节,对诊断颌面部脉管性疾病具 有诊断价值,同时双能虚拟平扫技术可减 低儿童受检者的放射剂量。
Objective To evaluate the diagnostic value of Dual-source CT in maxillofacial vascular anomalies. Methods Twenty-four patients of maxillofacial vascular anomalies who underwent dual source CT were retrospectively analyzed.The reconstruction techniques included multi-planar reformation(MPR), maximum intensity projection(MIP), volume rendering(VR)and dual energy bone remove technology, and nonenhanced images of 13 children were obtained by using virtual non-contrast software. Results In 24 cases of maxillofacial vascular anomalies,18 cases were hemangioma, which occurred in parotideomasseteric region(n=6), in buccal(n=3), in orbital(n=2), in front of the ear(n=2), in nasal(n=2), in lip(n=3), in CT plain scan images, hemangioma appeared as subcutaneous round soft tissue mass with homogeneous and medium density, 3 cases accompanied with phleboliths, on contrast CT scan,15 hemangioma showed linear progressive enhancement in different degree,when 3 cases showed not or slight enhancement; 6 cases were vascular malformation, all vascular malformation showed abnormal vascular plexus with irregular significant enhancement, and feeding arteries, drainage veins and collateral vessel were seen in MPR, VR images. Conclusion Dual source CT bone remove technology and post processing technique can clearly display the details of maxillofacial lesions and abnormal vessels. Dual source CT has significance diagnostic value in maxillofacial vascular anomalies, Dual energy virtual non-contrast software can reduce the radiation dose of children.
【关键词】双源CT;颌面部;脉管性病 变;血管瘤;血管畸形;
【中图分类号】R543.4;R445.3
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2017.04.016
前言
脉管性疾病发生在颌面部者约占60~80%[1],治疗可归结为手术及 非手术方法,手术是治疗血管瘤和脉管畸形的有效手段,术中应结扎 滋养动静脉,尽量完整切除肿瘤病灶,但对范围广泛深层、血供丰富 的病灶,手术难度及出血风险往往比较大;非手术包括糖皮质激素、 平阳毒素注射,如放疗、微波及激光治疗及介入[2-3],采用以整形外科 为原则的综合序列治疗,为大多数临床学者所提倡[4-5]。术前影像学检 查包括DSA、B超、MRI、CT。双源CT具有较高的空间分辨力、强大的 后处理技术,已较广泛应用于全身血管疾病的诊断。本研究回顾性分 析2009年1月至2014年9月行双源CT的24名颌面部脉管性疾病的影像资 料,以评价双源CT对颌面部脉管性疾病的观察效果,探讨其对颌面部 脉管性疾病的诊断价值。
中国CT和MRI杂志
第15卷, 第 4 期
2017年04月
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