【摘要】 目的 探讨螺旋CT容积漫游技术(VRT)三维成像方法，评价其临床应用范围与价值。 材料与方法 47例VRT三维重建病例包括：血管组19例，骨关节组16例，其他部位组12例；扫描技术及对比剂使用参数根据部位及病变性质具体设置，同时将VRT与SSD及MIP作简单比较。 结果 选择2或3个显示目标及其合适的CT值范围、不透明度百分率可获得良好的VRT立体成像，显示血管组病变13例包括血管畸形6例，血管栓塞、血管受肿瘤推压侵犯各2例，颈静脉球高位、烟雾病、胃底静脉曲张各1例；显示骨关节组病变14例中颅底骨折5例，关节面骨折3例，关节脱位、椎间孔变窄、椎间盘脱出各2例；其他部位组病变7例中脑积水2例，支气管肺癌、胃癌、结肠癌、脑血肿、肾外肾盂畸形各1例。 结论 VRT-3D血管造影是快速而有效的无创伤血管成像术，优于SSD及MIP，部分可替代DSA。VRT-3D骨关节显示清楚直观，有利于骨折、关节半脱位的诊断及测量，VRT-3D在尿路、气管支气管树、胃肠道、脑室等方面亦具有一定的临床应用价值。

DUAN Shaoyin, KANG Jianghe, HUANG Xien,et al.Department of CT & MR, Zhongshan Hospital of Xiamen, Xiamen, Fujian Province 361004,P.R.China

【Abstract】 Objective To optimize the parametersof volume rendering technique (VRT) 3D reconstruction on spiral CT, and to evaluate itsclinical applications. Materials and Methods VRT-3D was performed in 47 patients,which were divided into vascular group (n=19), osteoarticular group (n=16) and otherregions group (n=12). The parameters for scanning and contrast administration were devisedseparately according to the site and nature of the lesions. A brief comparison of VRT withSSD and MIP was made. Results High quality VRT-3D images were obtained with selecting2～3 objects with appropriate CT value. Vascular lesions were well displayed in 13 cases,including intracranial arteriovenous malformation (n=6), cerebral embolism (n=2), Moyamoyadisease (n=1), encased vessels due to meningioma (n=2), gastric varicose (n=1) and highlocated jugular glomus (n=1). Osteoarticular lesions were revealed in 14 cases, includingcranial fossa fracture (n=5), articular surface fracture (n=3), articular dislocation(n=2), stenosis of intervertebral foramen (n=2) and protrusion of intervertebral disc(n=2). Lesions in other regions group included hydrocephlus (n=2), bronchogeniccarcinoma (n=1), gastric carcinoma (n=1), colonic carcinoma (n=1), intracerebral hematoma(n=1) and extrarenal pelvis (n=1). Conclusion Spiral CT angiography with VRT is afast, noninvasive and effective method to image complex vascular structures and issuperior to SSD and MIP, thus, it can be used as an alternate to DSA. Osteoarticular 3Dimages with VRT are helpful for diagnosing and measuring fracture and articularhemi-dislocation. VRT-3D technique also has some value in assessing urinary tract, tracheo-bronchial tree, gastrointestinal tract and ventricle.

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