- 期刊
頭頸部電腦斷層腦血管攝影減像技術之臨床應用
Clinical Applications of Brain Computed Tomography Angiography with Subtraction
摘要
近年來電腦斷層腦血管攝影(computed tomography angiography; CTA)已被廣泛運用在頭頸部血管疾病的診斷，三維重組影像更能幫助我們清華的看見血管的全貌。然而因爲骨頭重疊增加顱底血管和椎動脈評估上的困難。使用減像(subtraction)技術可以輕易地去除骨頭並保留血管，提供清晰的血管影像。電腦斷層腦血管攝影由於有較高的解析度，並且沒有流速造成的假影，因此優於磁振造影血管攝影(magnetic resonance angiography; MRA)。此外，相對於數位減像血管攝影(digital subtraction angiography; DSA)，電腦斷層腦血管攝影較不具侵犯性，所以逐漸取代數位減像血管攝影。本研究從20個年3月至2009年5月共有44位接受CTA檢查之病患，將由l名有經驗的操作者對同一案例進行用傳統3D-rendering來顱骨影像刪減去除和減像技術處理時間來做統計，由本院資深神經放射線專科醫師來判讀做比較。結果用傳統3D-rendering來減去骨骼結構時間大約爲19~32 min而使用減像技術時間大約爲4~l0 min，此研究的44案例的影像，而認定使用減像技術成功率爲82%，再將檢查成功案例進行分級評分，同時檢討失敗的原因大部分是因爲病患身體位移所造成影像模糊。總之減像技術的推出克服了傳統CTA技術在影像判讀上的障礙，且操作簡便及省時，能提供高分辨率的血管影像。值得我們在臨床上應用與推廣。
並列摘要
In the past few years, Computed Tomography Angiography (CTA) has become one of the popular diagnostic tools for cephalic and cervical vascular diseases. Most of the diagnostic tools in the market are unable to create clear vessels images due to the overlapping images of bones and veins of the skull base and cervical spine's blood vessel This disadvantage can be overcome by CTA through its three-dimensional reformation that can easily clarify the overall vessels images. Subtraction technology can readily remove the bones images giving a clear picture of the vein images. The subtracted CTA technology is recommended over the use of Magnetic Resonance Angiography (MRA) technology because CTA can create better and higher resolution images. CTA also reduces flow-related artifact thus enabling dearer images. Furthermore, the CTA subtraction is much more user friendly therefore slowly is taking over the Digital Subtraction Angiography (DSA) market share. From March 2008 to May 2009, there were 44 patients that joined the clinical applications study with the assistant of experienced operator. This study focusing on the differences of timeline between the traditional three-dimensional rendering of the skull base with the subtraction technology. The study result was analyzed by senior nerve radiation specialists The study showed that the traditional three-dimensional rendering of the skull base takes 19~32 minutes while subtraction technology takes 4~10 minutes. Furthermore, from these 44 cases, the subtraction technology has 82% successful rate. Most of the unclear images are caused by patients during their radiation session. Patients are unable to keep still during the session. Overall, the subtraction technology can overcome many of the traditional CTA disadvantages. The subtraction technology is user friendly, efficient, and give higher quality of vessels images. The development of subtracting technology under clinical expansion and application has become an important task.