下肢双能CTA的临床应用

目的:研究双能CTA下肢动脉成像技术的临床应用价值。方法:43例患者进行双能下肢CTA检查,得到双能去骨后的图像(包括去除钙化斑块后的图像)及传统手动去骨后的图像,分别记录两者去骨时间及对各血管节段的侵蚀度。其中13例患者1周内行血管造影检查,并进行相同血管节段对照研究。结果:双能去骨时间(1.86±0.28)min低于传统手动去骨时间(5.54±0.63 min),P<0.01,t=-34.962;共对903节段血管进行分析,血管侵蚀率前者低于后者,且最常发生于小腿部血管(χ2=4.13,P<0.05)。CTA与DSA对下肢动脉狭窄程度诊断一致性非常好,K=0.953,敏感度、特异度、准确度分别为98.8%、93.3%、96.9%。结论:双能自动去骨方法较传统手动去骨方法提高了工作效率,增加了小腿部血管的显示率,自动去斑块功能可提高狭窄程度判定的准确性。双能CTA在评价下肢动脉阻塞性疾病方面与DSA具有非常好的一致性,是下肢动脉疾病的一种可靠的影像学诊断方法。

Clinical Value of Dual-energy Computed Tomography Angiography in Lower Extremity

Objective To study the clinical value of dual-energy computed tomography angiography in lower extremity. Methods Forty-three patients were scanned by dual energy CT, and dual energy automatically bone-subtracted images as well as bone and plaque subtracted images and standard manual bone subtraction images were gotten. Operation time for bone removal and presence of vessel erosions were measured. 13 cases underwent DSA in one week. The accuracy of dualenergy CT angiography and conventional digital subtraction angiography was compared, Results The time of dual energy automatically bone-subtraeted（1.86±0.28min）was significantly lower than the duration of standard manual bone subtraction （5.54±0.63min, P〈0.01, t=-34.962）. A total of 903 arteries were analyzed, compromising vessel erosions were observed less frequently in automatically bone-subtracted images than in standard manual bone subtraction images, especially in the lower extremity arteries（x2=4.13, P〈0.05）. The results coherence of CTA and DSA was very good, K=0.953, delivered a sensitivity of 98.8%, a specificity of 93.3%, and an accuracy of 96.9%. Conclusion Compared with standard manual bone subtraction, dual energy automatic bone subtraction is more time efficient and reliable, especially in the lower extremity arteries. Automatic plaque subtraction can improve the accuracy of the diagnosis. There is an excellent agreement in detecting peripheral arterial obstructive disease for DECTA and DSA. DECTA is a reliable diagnostic method for the detection of lower extremity arterial occlusive disease.