| Objectives To explore the feasibility of low doses and high concentration contrastagent which was used in256-slice spiral CT splenic artery imaging; Apply256-slicespiral CT to perform splenic artery, observe the splenic artery’s normal anatomy andvariation, and to explore its clinical value.Methods1100patients who underwent splenic artery angiography with256-slicespiral CT were randomly divided into two groups: study group of50patients, injectedhigh concentrations of contrast agent Iopromide (370mgI/mL)50ml and saline20ml;control group of50patients injected70ml contrast agent concentration iohexol(300mgI/mL). The injection rates were all4.0ml/s of the two groups. Both groupsinterested in abdominal aorta in monitoring level in CT values of pre-set thresholdcomputer automatic trigger after the scanning, set the threshold for150Hu, choosedabdominal aorta celiac axis horizontal, spleen and spleen in middle artery sounding pipecavity contrast-enhanced CT value, compared the contrast medium enhancement level ofthe two groups, statistic and analyzed the detection rate of the two groups of splenicartery branches and to evalute the image quality.2The100patients which were selectedhad no spleen and splenic vascular’s disease as research object, these patients were all dothe superior belly enhancement scan by256-slice spiral CT, the images were allreconstructed for0.625mm thin layer and sent to EBW workstation, based on multipleplanar reconstruction (MPR), volume representation (VR), maximum density projection(MIP) processing, et al, observed the splenic artery normal anatomy and variation,explored the application value of splenic artery256-slice spiral imaging beforelaparoscopic splenectomy and spleen embolization preoperative examination, analyzed256-slice spiral CT ‘s advantages in splenic artery imaging.3Statistical methods: Usedthe SPSS17.0statistical software for data analysis. Measurement data withx±s;Classification information and the comparison of the rate with χ2test; comparisonbetween groups used independent sample t-test; correlation used bivariate correlationanalysis: difference was statistically significant (P <0.05).Results1The low dose and high concentration of contrast medium and theconventional dose contrast medium concentration level of two groups of abdominal aortaceliac, spleen and spleen in middle artery in contrast medium concentration, the studygroup was higher than the control group, the difference between the two groups wasstatistically significant (P <0.01), respectively: the study group347.7±46.6Hu,347.7±49.9Hu,293.5±50.2Hu, the average320.81±47.43Hu; control group276.4±47.2Hu,276.4±44.4Hu,175.9±44.0Hu, the average224.67±39.01Hu. The detection rate of twogroups of splenic artery branches at all levels to compare difference was statisticallysignificant （P <0.05）, the study group level3vascular branch’s show rate was higherthan the control group; The splenic artery image quality score more similar between thetwo groups has no statistical significance (P>0.05).2Splenic artery origin for normal type for85cases (85%), the origin of variation of15cases, the mutation rate was15%,there was no statistically significant difference mutation rates between different gender(χ2=1.050，P>0.05). Splenic artery energyconsuming terminal branch in35cases,62cases of dispersible. Splenic lobe artery one type3cases, two type83cases,14cases ofthree type. There were10cases showed the upper pole of the splenic artery,15casesshowed the lower pole of the splenic artery. The splenic artery diameter is3.42～8.32mm, the average (5.86±1.08) mm; End of the splenic artery diameter is1.92～6.41mm,the average (4.24±0.87) mm; Splenic lobe arterial diameter is1.20～5.86mm, theaverage (3.35±0.87) mm; Splenic artery trunk length was7.20～19.30mm, the average(12.22±2.09) mm; Spleen index was113.4～884.0cm3, the average (390.65±151.48) cm3.The splenic artery diameter,end of the splenic artery diameter, spleen leaf arterydiameter and length of splenic artery between different gender, comparative differencewas statistically significant, P <0.05; The splenic artery diameter the ends of splenicartery diameter, spleen leaf artery diameter and length of splenic artery between differentage groups, there was no statistically significant difference, P>0.05. Spleen indexcomparison between different gender difference was statistically significant, P <0.05;The spleen index comparison between different age groups, there was no statisticallysignificant difference, P>0.05. The splenic artery diameter, the ends of splenic arterydiameter and splenic artery diameter and spleen index correlation, P <0.05, andpositively correlated. Splenic artery trunk length has no correlation with the spleen index,P>0.05, there was no statistically significant difference. Splenic artery in65cases wentabove the pancreatic tail,24cases went behind the pancreatic tail,11cases went behindthe pancreatic tail.Conclusions1The splenic artery imaging by256-slice spiral CT, high concentrationsand low doses of contrast medium can be meet the requirements of clinical diagnosis ofsplenic artery CT angiography image, and reduce the possibility of a contrast mediumadverse reaction, worthy of clinical application.2The splenic artery256-slice spiral CTimaging can clearly display the splenic artery in vivo anatomical morphology structureand the variation of normal space, and related data measurement, has a guidingsignificance to laparoscopic splenectomy, and for partial splenic embolization to explorea simple, accurate and reliable method to control the degree of embolism and provideanatomical reference to choose the appropriate catheter godet.3256-slice spiralCT has technical advancement and powerful blood vessels post-processing analysissoftware which is used for splenic artery vascular imaging. |
PDF Full Text Request