MSCTA在下肢动脉硬化闭塞症中的应用

目的探讨多排螺旋CT血管成像(MSCTA)在下肢动脉硬化闭塞症斑块及狭窄分析中的应用价值。方法选择下肢动脉硬化闭塞症患者69例,分为单纯糖尿病(DM)组36例及单纯高血压(HP)组33例,使用64排螺旋CT行下肢动脉MSCTA检查,采用动脉造影的12分段积分法,分析2组病例各个血管节段的斑块分布情况(斑块检出率)、范围、斑块性质及血管狭窄程度,侧支循环建立情况。结果膝以上大动脉病变中,DM与HP组血管斑块均以混合斑块为主,二者检出率、动脉病变狭窄程度积分无统计学差异(P>0.05)。膝以下小动脉斑块中,DM组以硬斑为主,HP组以软斑为主,DM组检出率明显高于HP组(P<0.05);DM组与HP组病变狭窄程度积分有统计学差异(P<0.05)。2组均有侧支循环形成,DM组明显多于HP组,且以膝以下血管为主,HP组则以膝以上血管为主。结论糖尿病与高血压病下肢动脉硬化闭塞症斑块及狭窄程度有所不同,多排螺旋CT血管成像可以精确显示下肢动脉粥样硬化斑块。

Application of MSCTA in the arteriosclerosis obliterans of lower limbs

Objective To investigate the value of multi slice spiral computed tomographic angiography （MSCTA） in plaques analysis of lower limb arteriosclerosis block disease. Methods 69 patients with lower limb arteriosclerosis block disease were grouped into DM group （36 cases） and HP group （33cases）. 64 slice spiral CT was performed in lower limb artery, which is divided into 12 segments by the 12 subsection integral method of arteriography. Analysis the patch distribution （plaques detection rate） , scope, plaques properties and artery stenosis degree, collateral degree of each vascular segment of two groups. Results In knee following small arteries lesions, the detection of plaques of DM group was significantly higher than HP group, and the former most with hard spot, the latter with soft spot. The lesions narrow degree of DM group and HP group found statistically significant （ P 〈 O. 05 ）. Both DM group and HP group have collateral circulation. The DM group, who＇ s were most knee above, primarily more than HP group, whose were below knee. In knee above artery, the plaques of the two groups were mainly mixed patches. The detection of the patches and the arteries narrow degree integral of the two groups didn＂t have statistical significance （ P 〉 0.05 ）. Below knee arterial plaque, DM group with calcified mainly, HP group with soft plaque dominated, DM group was higher than that HP group （ P 〈 0.05 ） ; DM group and HP group lesion stenosis points were significantly different （ P 〈 0.05 ）. Two groups had collateral circulation, DM group was significantly more than the HP group, and to the main blood vessels below the knee, HP group places the main artery above the knee. Conclusion The plaque distribution and properties of lower limb artery atherosclerosis in diabetes and hypertension have differences. multi slice spiral CTA can show it accurately.