Exploration On Multi-Slice Spiral CT Angiography Of Stomach

Objective: To explore the clinical value of MSCTA in the visualization of the gastric arteries and to investigate imaging features of the Right Gastroepiploic Artery(RGEA) using multi-slice spiral CT angiography (MSCTA).Methods: CTA using a Siemens Sensation 16 scanner was performed in 80 cases excluding abdominal surgery and Stomach disease and 20 cases of gastric cancer. Reconstructing with 0.75 mm slice thickness, 0.4mm reconstruction interval on workstation. CTA of gastric artery were made using VR(volume rendering), MIP( maximum intensity projection) and TSMIP(Thin slice maximum intensity projection)techniques. Reconstructing normal gastric artery (including left gastric artery, right gastric artery, right gastroepiploic artery and left gastroepiploic artery, posterior gastric artery, short gastric arteries) and the feeding artery of gastric cancer. Two radiologists evaluated together and recorded the frequency and degree of visualization of the feeding arteries of stomach. Observing RGEA Traveling, the type of length and measuring the diameter of the Vascular at the start and the end . Results: The left gastric artery and right gastroepiploic artery were all seen in each technique.In VR, MIP, TSMIP, visualization rates of the right gastric artery were 50.00%,70.00%,90.00%,respectively;left gastroepiploic artery, 30.00%,60.00%,77.50%; posterior gastric artery, 6.25%, 16.25%, 25.00%; short gastric artery 10.00%, 25.00%, 40.00%. There was significant difference in visualization rates of right gastric artery, left gastroepiploic artery , posterior gastric artery, short gastric artery between VR and TSMIP. So did they between VR and MIP. There was significant difference in visualization rates of right gastric artery, short gastric artery between MIP and TSMIP .There was significant difference in the degree of visualization of the feeding arteries of stomach among TSMIP, MIP or VR. 20 cases of gastric cancer, 19 feeding arteries were successfully displayed, of which 12 cases of gastric cardiac tumors, gastric antrum tumors in 7 cases, one case of greater curvature tumor failed to show the feeding artery. In 80 cases RGEAs were all showed. They come from the gastroduodenal artery along the greater curvature of stomach, there were longer RGEA in 22 cases(27.5%), medium length in 53 cases(66.25%), shorter in 5 cases(6.25%). The average length of RGEA was (19.5±4.5)cm ,the average diameter of the beginning of three types REGAs respectively was about (2.69±0.26)mm,(2.70±0.18)mm,(2.68±0.12)mm. the average distal diameter of three types REGAs was respectively about (1.76±0.17)mm,(1.75±0.18)mm,(1.74±0.05)mm . The average diameter of three different length RGEAs was no statistical significance (P> 0.05).Conclusion: The gastric arteries are displayed on TSMIP more better than on VR and MIP. The gastric arteries have three-dimensional sense of space on VR .The anatomic features and the variations of the gastric arteries can be accurately displayed by VR and TSMIP. At the same time the relationship of the feeding arteries of gastric cancer with the tumor was demonstrated on TSMIP. MSCTA can clearly demonstrate anatomical structures of RGEA,and provide vascular anatomy information for evaluating RGEA before Coronary artery bypass grafting.