目的 探讨螺旋CT后处理容积重 建(VR)对胸主动脉瘤的应用价值。方法 选取我院2015年1月-2017年1月收治的胸 主动脉瘤患者43例，患者均行多层螺旋CT 检查，收集43例患者的临床资料、影像学 资料，观察患者多层螺旋CT平扫及VR图 像，比较两种检查对胸主动脉瘤的检出 率，分析其应用价值。结果 经整理资料 发现，CT平扫对胸主动脉瘤的检出率为 79.06%(34/43)，VR对胸主动脉瘤的检出 率为100%(43/43)，CT平扫对胸主动脉瘤 检出率明显低于VR，差异具有统计学意 义(χ2 =8.009，P<0.05)；43例患者中， 胸主动脉瘤在CT平扫中主要表现为主动 脉囊状或梭性型膨出，主动脉局部增粗或 形态异常，少数患者伴有胸膜腔积液， 55.81%(24/43)患者血管边缘性呈现弧形 钙化，位于升主动脉者瘤体均>4厘米，平 均直径(4.51±0.57)cm，位于降主动脉者 瘤体平均直径(3.01±0.35)cm；CT增强 后图像主要表现为瘤体轻-中度强化，局 部突起部分亦可见造影剂填充；VR可以 直观、立体的显示主动脉弓上的局部突 起，瘤体与正常主动脉区分较为明显，在 MIP、MPR图像的基础上清楚显示瘤体外观 形态，清晰、准确显示血管走形、主动脉 整体形态。结论 螺旋CT后处理容积重建 能直观、立体的显示胸主动脉瘤的具体位 置、形态，检出率高，可为临床制定手术 方案提高可靠影像学资料。

Objective To evaluate the value of spiral CT postprocessing volume reconstruction (VR) in thoracic aortic aneurysm. Methods Select 43 cases of thoracic aortic aneurysm treated in our hospital from January 2015 to November-2016, patients were examined by multi-slice spiral CT, and collect the clinical data and imaging data of 43 cases, to observe the multi-slice spiral CT scan and VR images, compare the detection rate of two kinds of examinations for thoracic aortic aneurysm, and analyze its application value. Results The detection rate of CT scan in thoracic aortic aneurysm was 79.06% (34/43), the detection rate of VR in thoracic aortic aneurysm was 100% (43/43), and the detection rate of CT scan for thoracic aortic aneurysm was lower than VR, the difference was statistically significant (χ2 =8.009, P<0.05). In 43 patients, thoracic aortic aneurysms were characterized by cystic or spindle shaped bulging of the aorta during CT scan, local thickening or abnormal morphology of the aorta, a small number of patients with pleural effusion, 55.81% (24/43) patients with marginal calcification of the arc, tumors in ascending aorta are >4 cm in diameter and (4.51±0.57)cm in diameter, the average diameter of tumor in descending aorta was (3.01+0.35) cm. After CT enhancement, the images were mainly light to moderate enhancement of the tumor, and the local protrusion was filled with contrast medium. VR can visually display the local protuberance on the aortic arch, the tumor and normal aorta obviously different, clearly show that the tumor morphology based on MIP and MPR images, clearly and accurately display the vessel shape, the overall shape of the aorta. Conclusion The volume and reconstruction of spiral CT can display the location and shape of thoracic aortic aneurysm in an intuitive and three-dimensional manner, with high detection rate. It can be used as an operation plan for clinical and improve reliable imaging data.