下肢动脉闭塞性病变的64层CT血管造影与DSA的对照研究

目的对照DSA,研究64层螺旋CT血管造影(CTA)对下肢动脉闭塞性病变诊断的临床应用价值。方法对31例下肢动脉闭塞性病变患者行64层螺旋CTA检查,检查后2周内行DSA。CT数据重建采用最大密度投影、容积重建及多平面重建技术。DSA采用步进跟踪造影技术或分段DSA进行下肢血管检查,将CTA与DSA结果比较。结果在216个动脉节段中,2种检查方法狭窄程度显示一致的有157个,被CTA高估13个,低估6个。CTA对下肢动脉狭窄程度≥50%诊断的灵敏度为98.21%,特异度96.15%,准确率97.22%,阳性预测值96.49%,阴性预测值98.04%。结论64层CT血管造影是下肢动脉闭塞性病变评估的可靠方法,可为制订介入治疗方案提供准确的参考依据。

The comparative study of 64-slices spiral CT angiography with DSA in lower extremity arterial occlusive diseases

Objective To study the clinical value of 64-slices spiral CTA with DSA comparatively in diagnosis of lower extremity arterial occlusive diseases.Methods 31 patients with lower extremity arterial occlusive diseases underwent 64-slice spiral CT angiography of lower extremity arteries and they also underwent digital subtraction angiography(DSA)two weeks later.Reconstruction by maximum intensity projection(MIP),volume render(VR)and multiplanar reformatting(MPR)in working-station was undertaken comparing with the bolus chase DSA and traditional DSA for diagnostic accuracy.Results The 216 arterial segments of lower extremity were selected,including 157 segments with consistent results in demonstrating degree of stenosis by both examinations.On CT angiography,5 segmental stenosis were overestimated and 9 were underestimated.When stenosis of detected segments is more than 50%,the sensitivity,specificity,accuracy,positive predic-tive value,and negtive predictive value of CTA were 98.21%,96.15%,97.22%,96.49%,and 98.04%,respectively.Conclusion 64-slices spiral CT angiography is an effective and reliable method for evaluating the lower extremity arterial occlusive diseases and may provide precious information for planning interventional therapy.