64层螺旋CT后处理技术评价下肢血管损伤

目的 探讨64层螺旋CT后处理技术显示下肢血管损伤的优缺点及应用价值。方法 分析行64层螺旋CT血管造影(CTA)检查的下肢血管损伤的30例患者的血管重组图像,比较各种图像后处理技术对下肢动脉损伤的显示效果,30例患者包括16例单纯动脉损伤,10例假性动脉瘤,4例动静脉瘘,其中8例为下肢骨折内固定术后。10例假性动脉瘤患者同时行数字减影动脉造影(DSA)检查及破口修复术,15例单纯动脉损伤经手术证实,其余5例病例经磁共振血管造影(MRA)等检查和随访证实。比较各种图像后处理技术对下肢动脉损伤的显示效果。结果 30例患者CTA都能清晰显示下肢动脉损伤,与原始轴位和MPR/CPR相比,MIP及VR诊断动脉狭窄的准确性分别为70.59%(12/17),58.82%(10/17)。CTA对血管损伤的诊断与DSA、手术所见及MRA等相关检查随访完全相符,但CTA对下肢动脉损伤后血栓形成诊断的准确率为60.71%(17/28)。结论 64层螺旋CTA可准确、直观显示下肢动脉损伤情况。各种下肢血管后处理成像技术中,MPR/CPR结合原始轴位对下肢血管损伤显示最佳,VR对手术定位有很好的辅助作用。

Diagnostic value of 64-slice CT post-processing techniques in lower extremity arterial injury

Objective To investigate the diagnostic value of 64-slice spiral CT angiography post-processing techniques in lower extremity arterial injury. Methods 30 patients with lower extremity arterial injury including simple arterial injuries (16), pseudoaneurysm (10), and arteriovenous fistula (4) underwent CT angiography with MPR/CPR, MIP and VR reconstruction. The effectiveness of these image post-processing methods was compared. Results All arterial injuries were clearly displayed with accuracy of 70.59% (12/17) on MIP and 58.82% (10/17) on VR for diagnosing arterial stenosis, 60.71% for diagnosing arterial thrombosis in comparison with axial display and MPR/CPR. Conclusion 64-slice spiral CT angiography can accurately show lower extremity arterial injury. MPR/CPR combined with the axial images was the best post-processing display whereas VR can aid surgical planning.