The Research Of64-slice Spiral CT Angiography In Abdominal Vessel

Objective:To observe the displays of abdominal artery with the64-slice spiral CT angiography; To understand the variations and its types of anatomy in abdominal artery and further to discuss its clinical significance; To observe the occurrence and distribution of atherosclerotic plaque in general population, and further to discuss its distribution and clinical value.Methods:145consecutive patients, taking abdomen enhancement scanning by GE Light Speed64-slices VCT machine in Tianjin4th center hospital were selected as the object of this research. All raw data collecting from the enhancement scanning of all patients were transmitted to the ADW4.4CT workstation. And then the data were processed by MPR, VR、MIP、TS-MIP、VP.①Observe the display situations of hepatic artery, perigastric arteries anatomy,celiac axis,inferior phrenic artery, superior mesenteric artery, the direct feeding arteries of pancreas, renal artery. Then record the display rate. Analyze the origins and mutation rates of hepatic artery, perigastric arteries anatomy,celiac axis,inferior phrenic artery,superior mesenteric artery,the direct feeding arteries of pancreas and renal artery. And then to classify of the mutation of hepatic artery, celiac axis, inferior phrenic artery and renal artery.②All145patients were divided into two groups by sex--male and female. All145patients were divided into five groups:40years old of the following;40-years old;50-years old;60-years old;70years old and above. Observe the abdominal artery atherosclerosis, and then view the tube walls and lumen of branches level lto3in abdominal artery by using the VP technology. Therefore to inspect the atherosclerotic plaques, including soft plaque, calcific plaque and mixed plaque. And then to analyze the stenosis of artery. All the statistics were analyzed and processed by SPSS19.0and Microsoft Office Excel2003. The sex difference of incidence rates of all atherosclerotic plaques of abdominal in all branches was checked by independent sample-t, and Sig<0.05indicating statistical differences. The differences of incidence rates of all atherosclerotic plaques of abdominal in all branches and that among every age group were checked by One-way ANOVA and Dunnett T3, and P<0.05indicating statistical differences. Results:①The hepatic artery level1branch of all the145cases were100%displayed.4cases of level1branch were displayed, accounting for2.8%.56cases of level2branch were displayed, accounting for38.6%.85cases of level3and above branches were displayed, accounting for58.6%. Michels I, that’s100normal types (69.0%). There’re45cases of the origin of hepatic artery variation (31.0%). Of all cases of the origin of hepatic artery variation,22were Michels types(15.2%), of which6were Michels II (4.1%),8were Michels111(5.5%),7were Michels V(4.8%),1were MichelsVI(0.7%). Cases of Michesl III type was the largest. And23cases in12types didn’t belong to Michesl classification(15.8%), of which the common hepatic artery trifurcation accounted for the most-8cases(5.5%).②The left gastric artery were100%displayed, so did the right gastroepiploic artery.110cases of right gastric artery were displayed, accounting for75.9%.82cases of left gastroepiploic artery were displayed, accounting for56.6%. And66for short gastric arteries,45.5%.64for arteria gastrica posterior,44.1%.There’re3cases of accessory left gastric artery(2.1%), of which1for common hepatic artery, proper hepatic artery and left hepatic artery respectively. The right gastric artery origins changed much greater. Of all the110cases in this group,84right gastric artery were starting from proper hepatic artery(76.4%),17were starting from left hepatic artery(15.5%),5were starting from gastroduodenal artery(4.5%),4were starting from common hepatic artery(3.6%). There’re142cases of right gastroepiploic artery starting from gastroduodenal artery(97.9%), and3cases starting from superior mesenteric artery(2.1%).③All celiac axis were100%displayed. There were135cases of Michels I type (93.1%),5cases of Michels II type(3.4%),2cases were Michels IV type(1.4%),1cases of Michels V type(0.7%). And still2cases didn’t belong to the classification(1.4%).④Of all the145patients,286cases of inferior phrenic artery were displayed,2were not displayed for right inferior phrenic artery and left inferior phrenic artery respectively, and the display rates were the same-98.6%. The incidence rates of type A、B、C、D of right inferior phrenic artery were26.6%、47.6%、18.9%、2.1%respectively, and there were7cases which did not belong to Loukas classification(4.9%). While the incidence rates of type A、B、C、D of left inferior phrenic artery were44.1%、43.4%、2.8%、2.1%respectively, still there were11cases which did not belong to Loukas classification(7.7%).⑤The display rates of level1、level2and level3of renal artery branches were100%.113patients showed3grade-branch renal artery(77.9%), while32patients showed4grade-branch renal artery(22.1%). Of all the145patients, there’re63patients who had anatomical variations of right renal artery, accounting for43.4%. And32cases belonged to category I. There’re6cases of type IA(4.1%),21cases of type IB(14.5%),5cases of type IC(3.4%). Also,24cases were of category II. There’re4cases of type IIA(2.8%),17cases of IIB(11.7%) and3cases of IIC(2.1%). Besides,4cases were of category III(2.8%),3cases were of category IV(2.1%).There’re61patients who had anatomical variations of left renal artery, accounting for42.1%. And30cases belonged to category I. There’re8cases of type IA(5.5%),17cases of type IB(11.7%),5cases of type IC(3.4%). Also,26cases were of category II. There’re5cases of type IIA(3.4%),17cases of IIB(11.7%) and4cases of IIC(2.8%). Besides,4cases were of category III(2.8%),1case were of category IV(0.7%).⑥139cases of anterior superior pancreaticoduodenal artery out of all145cases in this goup were displayed, and the rate was95.9%. And114cases of posterior superior pancreaticoduodenal artery were displayed, the rate was78.6%.107cases of anterior inferior pancreaticoduodenal artery were displayed, and the rate was73.8%.102cases of posterior inferior pancreaticoduodenal artery were displayed, and the rate was70.3%.121cases of dorsal pancreatic artery were displayed, and the rate was83.4%.101cases of transverse pancreatic artery were displayed, the rate was69.7%.97cases of magnificent pancreatic artery were displayed, the rate was66.9%.49cases of caudal pancreatic artery were displayed, the rate was33.8%.58cases of arterial arcades of pancreatic head around were displayed, the rate was40%. Of the arterial arcades of pancreatic head around,35cases of the double arches were displayed with the rate24.1%;23cases of the single arch--19front arches and4back arches--Were displayed with the rate15.9%.There’s a greater changes of the origins of dorsal pancreatic artery. Of all121cases in this group,64cases of dorsal pancreatic artery were starting from proximal splenic artery(52.9%);33cases were from superior mesenteric artery(27.3%);15cases were from proximal common hepatic artery(12.4%);5cases were from celiac axis(4.1%);2cases were from variated right gastroepiploic artery(1.7%); and2cases were from alternative right hepatic artery(1.7%). Besides, of the114cases of posterior superior pancreaticoduodenal artery,112were from gastroduodenal artery,with a share of98.2%; and the other2were from proper hepatic artery, which accounted for1.8%.⑦In this group,15cases of3grade-branch of superior mesenteric artery were displayed(10.3%);83cases of4grade-branch were displayed(57.2%); and47cases of5grade-branch and above were displayed(32.4%). Jejunal artery, ileal artery and ileocolic artery were all100%displayed.118cases of right colic artery were displayed and the rate was81.4%.104cases of middle colic artery were displayed and the rate was71.7%. And107cases of inferior pancreaticoduodenal artery were displayed and the rate was73.8%. All superior mesenteric arteries of this group were all starting from abdominal aorta. Of all the107displayed cases of inferior pancreaticoduodenal artery,65were from proximal superior mesenteric artery(60.7%);42were from the first branch of jejunal artery(39.3%).⑧124patients were found atherosclerotic plaques in abdominal artery or branches of all levels out of145patients in this group, and the incidence rate was85.5%; while21patients were not found atherosclerotic plaques, and the rate was14.5%. And302plaques were found in all branches of abdominal artery,49soft plaques (16.2%),150calcific plaques (49.7%) and103mixed plaques (34.1%), obviously the number of calcific plaques were the most.15cases showed no obvious difference of arteriosclerosis between the superior abdominal artery and the inferior abdominal artery;109cases had worse arteriosclerosis in the inferior abdominal artery than in the superior; and0cases showed worse arteriosclerosis in the superior abdominal artery than in the inferior.69patients had230atherosclerotic plaques which accounted for76.2%of the whole plaques in level1branch of abdominal artery, and the incidence rate was47.6%. Among them, the incidence rate of atherosclerotic plaques in superior mesenteric artery was the highest--32.4%; and the rate of that in left renal artery was29.7%; and the rate of that in right renal artery was 26.2%. The plaques of the level1branch mainly distributed on peristome and proximal segment of vessels.22cases of atherosclerotic plaques were found in level2branch of abdominal artery, and the incidence rate was15.2%. Of the22cases, the incidence rate of atherosclerotic plaques in splenic artery was the highest--13.8%. And the plaques of splenic artery mainly spread on the middle parts, while other plaques were on peristome and proximal segment of vessels.13cases of atherosclerotic plaques were found in level3branch of abdominal artery, and the incidence rate was9.0%. There’re17plaques, accounting for5.6%of the whole plaques. And the incidence rate of atherosclerotic plaques in level2branch of splenic artery was the highest--8.3%. Also, the plaques mainly distributed on peristome and proximal segment of vessels. There’s no statistical significance of incidence rate of plaques in different branches of abdominal artery between male and female. However, differences of incidence rates existed between that of different age groups. In general, the incidence rate of plaques was in direct proportion to people’s age. There’s obvious difference between level1branch and level2, level3branches, so was that between level2branch and level3branch. It has been found in this group that there’re219cases of stenosis of degree I,55of degree II,15of degree III and13of degree IV.Conclusion:The64-slice Spiral CT, a safe, convenient, noninvasive, accurate and quick inspection method, can display the space anatomical structure and variations of normal abdominal artery in a direct and three-dimensional way. The origins and branch variations of abdominal artery are quite complex. And the artery of all internal organs are interrelated with one another, which is worthy of high attention clinically. The accurate displays of64-slice Spiral CT in abdominal artery can provide rich angiography information to clinical diagnosis and treatment. The incidence rate of atherosclerotic plaque was higher in general population. The arteriosclerosis in the inferior abdominal artery was more often that not much worse than in the superior. And the plaques of different grade-branches in artery mainly distributed on peristome and proximal segment of vessels. Among all grade-branches in abdominal artery, the plaques were much likely to be found on level1branch. There exited a tendency that the incidence rate of plaques grew with age. With high spatial and temporal resolution, 64-slice Spiral CT can be used to carry out the screening and diagnosis of atherosclerotic plaque in abdominal artery in a wide range conveniently and non-invasively.