| Objective By analyzed the convex side branch vessels of aortic arch on human body in the multi-slice CT angiography, this study related to the variation of branches of aortic arch, observed the branching location of the three branch vessels of standard aortic arch, anatomic quantitative measured them, hoped to provide help for clinical work.Data and Method By following the selection criteria, we collected 237 cases multi-slice spiral CT angiography of neck, using a variety of image processing technique; aortic arch reconstruction images were studied. All patients underwent volume rendering and multi-planar reconstruction (MPR), and multi-angle, multi-slice, three-dimensional observed the anatomical structure of the aortic arch and its major branches,Observe 211 cases of standard aortic arch volume rendering image, recorded the branching location of the brachiocephalic artery, left carotid artery and left subclavian artery inaortic arch branches.The original axial images as the basis, we can determined the angle with the sagittal plane and the MPR oblique plane which contains the distance between the brachiocephalic artery and left carotid artery and the angle with the sagittal plane and the MPR oblique plane which contains the distance between the left carotid artery and left subclavian artery. Obtain the volume reconstructive MPR oblique images. Then obtain the volume rendering images that is based on these MPR oblique images. Measured the distance between the brachiocephalic artery and left carotid artery and distance between the left carotid artery and left subclavian artery and read the diameter of the brachiocephalic artery, left carotid artery, left subclavian artery on best observation plane. Using SPSS 17.0 software to analyzed these distance and these vessel's diameter and analyzed the age and gender difference of these distance and these vessel's diameter whether existing.Results①Aortic arch is divided into two types, standard and variant, of which the most common standard, the total number of cases of 89.03%, the total number of cases of variant of 10.97%.②Four different variant types were founded in the variant. the patients whose left vertebral artery and left carotid artery and left subclavian artery originated from the aortic arch, is 50% of the variant and 5.49% of the total cases; the patients whose brachiocephalic artery and left carotid artery were on the same trunk, is 38.46% of the variantand 4.22% of the total cases; the person whose left carotid artery originated on brachiocephalic artery and left vertebral artery, that located between the left carotid artery and left subclavian artery, originated from the aortic arch is 7.69% of the variant and 0.84% of the total cases; right aortic arch and vagal left subclavian artery cases were 3.85% of the variant and 0.42% of the total cases.③Standard aortic arch three branches in aortic arch:brachiocephalic artery openings located posterior persons as 87.67%, located superior persons 9.48% located anterior persons 2.84%; left carotid artery in aortic arch branch openings located aortic arch posterior persons as 7.58%, located superior persons 36.97% located anterior persons was 55.45%; left subclavian artery in aortic arch branch openings located posterior persons as 27.49%, located aortic arch superior as 60.19%, located anterior persons 12.32%.④Standard three branches of the aortic arch vessels:The maximum angle with the sagittal plane and the MPR oblique plane which contains the distance between the brachiocephalic artery and left carotid artery is 120.7°, the minimum is 14.6°,the average is 71.47°±2.16°, no age and gender differences; The maximum angle with the sagittal plane and the MPR oblique plane which contains the distance between the left carotid artery and left subclavian artery is 96.6°, the minimum is 3.6°, the average is 30.82°±1.62°, no age and gender differences.⑤The maximum distance between the brachiocephalic artery and left carotid artery is 19.60mm, the minimum is 0.80mm, the average is 5.59±0.48mm, no age and gender differences;The maximum distance between the left carotid artery and left subclavian artery is 24.2mm, the minimum is 0.80mm, the average is 8.76±0.63mm, no age and gender differences;⑥the maximum diameter of brachiocephalic artery in the aortic arch branch is 19.70mm, the minimum diameter is8.10mm, the average diameter of 12.74±0.35mm, no age and gender differences; the maximum diameter of left cartoid artery is 18.0mm, the minimum diameter is 3.30mm, the average diameter of 8.37±0.29mm, no age and gender differences; the maximum diameter of left subclavian artery is 17. Omm, the minimum diameter is 4.30mm, the average diameter of 10.07±0.31mm, no age difference, but gender difference, female is thick than man.Conclusions①Branches of the aortic arch type for the standard and variant, and the standard aortic arch is 89.03% of all cases,and the variant aortic arch is 10.97% of all cases which is consistent with previous reports of domestic and foreign literature.②Variant can be divided into four different types, and the percentage of each type is consistent with previous reports of domestic and foreign literature. However, in four type's variant aortic arch, left vertebral artery originated form aortic arch and located between left carotid artery and left subclavian is the most which is different from previous reports of domestic and foreign literature.③Standard branch of the aortic arch, brachiocephalic artery open more in the posterior wall of the aortic arch, left carotid artery and its branches open more in the anterior wall of the aortic arch, left subclavian artery over the opening in the superior wall of the aortic arch;④Standard three branches of the aortic arch, The angle with the sagittal plane and the MPR oblique plane which contains the distance between the brachiocephalic artery and left carotid artery is 71.47°±2.16°in average,120.7 in maximumn, and 14.6 in minimum, no age and gender differences The angle with the sagittal plane and the MPR oblique plane which contains the distance between the left carotid artery and left subclavian artery is 96.6 in maximum,3.6 in minimum and 30.82°±1.62°in average, no age and gender differences. So in the selective angiography, the best exposure angle of brachiocephalic artery is RAO 71°,but not LAO 30°in common.⑤The maximum distance between the brachiocephalic artery and left carotid artery is 19.60mm, the minimum is 0.80mm, the average is 5.59±0.48mm, no age and gender differences; The maximum distance between the left carotid artery and left subclavian artery is 24.2mm, the minimum is 0.80mm, the average is 8.76±0.63mm, no age and gender differences; The average distance between the brachiocephalic artery and left carotid artery is slightly shorter than the average distance between the left carotid artery and left subclavian.⑥The maximum diameter of brachiocephalic artery in the aortic arch branch is 19.70mm, the minimum diameter is 8.10mm, the average diameter of 12.74±0.35mm, no age and gender differences; the maximum diameter of left cartoid artery is 18.0mm, the minimum diameter is 3.30mm, the average diameter of 8.37±0.29mm, no age and gender differences; the maximum diameter of left subclavian artery is 17,0mm, the minimum diameter is 4.30mm, the average diameter of 10.07±0.31mm, no age difference, but gender difference, female is slightly thick. So in the clinical vascular stent selecting, after considering various factors, it can be selected according to different measurements of different types of vascular stents, in order to obtain the best treatment effect.
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