The Application Study On The Use Of The256Layer Spiral CT For Intercostal Artery Anglography

Objective1Research how different contrast media concentration and drug injectionrate influence the image quality of256MSCT intercostal artery.2Evaluate the appliedmeaning of managing technology in the process of Posterior IntercostalArtery (PICA) Angiography after256MSCT intercostal artery.3Adopt method ofPosterior Intercostal Artery (PICA) Angiography after256MSCT intercostal artery andresearch the anatomy of Posterior Intercostal Artery in order to provided informationinvolving the anatomy about Posterior Intercostal Artery for Surgical operation andinterventional therapy.Methods1Utilize256MSCT to conduct dual phase scanning of chest on432patients.All432cases are separated into four groups（Ⅰ~Ⅳ）,108cases in each group. Groupone: drug injection rate3ml/s, contrast agent concentration300mgI/ml (Iohexol300);Group two: drug injection rate4ml/s, contrast agent concentration300mgI/ml (Iohexol300); Group three: drug injection rate3ml/s, contrast agent concentration350mgI/ml(Iohexol300).2Utilize256MSCT to conduct dual phase scanning of chest on108patients (expect patients involved posterior intercostal arteries). All patients are separatedinto group A（MPR+VR）, group B（MPR+CPR）, group C（MPR+MIP） based onafter-treatment technology and observe posterior intercostal arteries.3Utilize（MPR+MIP）After-treatment technology to proceed posterior intercostal arteriesimaging on patients suspected suffering from chest space-occupying lesions ormediastinal lesion of large vessels in our hospital.Record every pair of posteriorintercostal arteries’ situation about existence, location, dimension, stream and truncusarteriosus.Results1when contrast agent concentration is350mgI/ml and drug injection rate is4ml/s, imaging quality of posterior intercostal artery is the best than others.2①In groupA（MPR+VR）, main reveal rate of posterior intercostal artery is87.35%. In group B（MPR+CPR）, main reveal rate of posterior intercostal artery is83.54%. In group C（MPR+MIP）, main reveal rate of posterior intercostal artery is94.19%.②Group A（MPR+VR）can reveal139posterior intercostal arteries completely and1559posteriorintercostal arteries incompletely. Group B（MPR+CPR）can reveal1216posterior intercostal arteries completely and408posterior intercostal arteries incompletely. GroupC（MPR+MIP）can reveal1714posterior intercostal arteries completely and117posterior intercostal arteries incompletely. So, Group C（MPR+MIP）show the bestgeneral-anatomic form of posterior intercostal artery.3①The situation of posteriorintercostal artery truncus arteriosus of108cases: there are13cases that nearby adjoiningposterior intercostal arteries are truncus arteriosus; there are58cases (53.70%) thatposterior intercostal arteries are truncus with right bronchial artery.②Left posteriorintercostal arteries mainly come from the posterior wall of thoracic aorta, the minor partcomes from the right posterior wall of thoracic aorta; the right posterior intercostalarteries is located at posterior wall of thoracic aorta, right posterior wall of thoracic aortand right wall of thoracic aort and spread from right posterior wall of thoracic aort toposterior wall of thoracic aort upside-down.③Posterior intercostal arteries become thickfrom upside to downside, and the ninth, tenth, and eleventh Posterior intercostal arteriesare the thickest.④Posterior intercostal arteries of both sides has different transitionalsituation beginning from aorta pectoralis. Right posterior intercostal arteries stretch overthe frontage of related Thoracic vertebrae and achieve intercostal space.Left posteriorintercostal arteries spread through left side of each thoracic vertebrae and achieveintercostal space.Conclusion1①Both contrast agent concentration and drug injection rate of256MSCT can infect imaging quality of posterior intercostal arteries.②Adopting highercontrast agent concentration（350mgI/ml）and faster drug injection rate（4ml/s）canachieve high-quality posterior intercostal artery images.2Applying MPR+MIP after-treatment technology in256MSCT can improve the reveal effect of anatomical structure,such as the spread of posterior intercostal artery.3256layers spiral CT imaging ofintercostals arteries after intercostals arteries had a higher rate.