目的 探讨320排螺旋CT直接法下腔静脉CT血管造影(CTP)的可行性及临床应用价值.方法 采用Aquilion One 320排螺旋CT对13例疑诊为下腔静脉阻塞的患者行直接法下腔静脉CTP检查,通过Vitrea 4.0后处理工作站对原始图像进行VR、MIP及MPR重建.由1名医师测量左肾静脉汇入下腔静脉处上方1 cm处的CT值,另2名医师采用9段分段法对下腔静脉及其属支的图像质量进行评价.结果 对13例患者均顺利完成下腔静脉CTP检查；CT值为(341.33±62.95)HU;13例共117个血管节段中,图像质量为优、良、中等、差的节段分别为64、29、16、8个.重建图像可直观显示下腔静脉的结构、病变部位、范围及狭窄程度.结论 直接法下腔静脉CTP用以诊断下腔静脉阻塞性病变切实可行,且具有较高的临床应用价值.%Objective To explore the feasibility and clinical application value of direct CT phlebography (CTP) in displaying inferior vena cava (IVC) with 320-row spiral CT scanner. Methods Thirteen patients with suspected obstructive IVC disease underwent direct CTP using Aquilion One CT scanner. Original image data were transferred to Vitrea 4. 0 workstation for post-processing including MPR, MIP and VR. The CT value of 1 cm above the abouchement to IVC and left renal vein was measured by one radiologist. Image quality of IVC and its branches were assessed by another two radiologists using 9-segment model. Results All CTP examinations were performed successfully. CT value of 1 cm above the abouchement to IVC and left renal vein was (341. 33 ± 62. 95) HU. Among the 117 vascular segments of 13 patients, image quality was excellent in 64 segments, good in 29 segments, acceptable in 16 segments and poor in 8 segments, respectively. The anatomy of IVC, the location and size of lesions and the severity of IVC stenosis were displayed vividly on reconstruction images of CTP. Conclusion Direct CTP is a feasible method for the diagnose of IVC obstructive diseases with significant clinical application value.
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