CT血管成像在下肢动脉疾病中的应用价值

目的探讨64层螺旋CT血管成像术在下肢动脉疾病中的应用价值及技术优势。方法对33例疑有下肢动脉疾病患者行64层螺旋CT增强扫描,扫描范围从肾动脉水平达足底。薄层重建横断面图像传入Wizard工作站,进行血管三维重建。结合常规血管造影评价64层螺旋CT血管成像术(CTA)的准确性。结果在693个动脉节段中,683个节段在CTA与DSA均可以显示。以DSA图像为标准,对于动脉完全闭塞,CTA诊断的敏感度、特异性、准确性分别为97.6%(95%CI,94.9%~100.7%)、98.9%(95%CI,98.0%~99.8%)、98.7%(95%CI,97.9%~99.5%)。CTA显示中度以上狭窄的敏感性、特异性及准确性分别为98.9%(95%CI,97.4%~100.4%)、99.4%(95%CI,98.7%~100.1%)、99.3%(95%CI,92.4%~99.9%)。结论64层CT血管成像在评估下肢动脉疾病方面与常规血管造影结果无明显差别,是下肢动脉疾病理想的影像学检查手段。

Applied Value of 64-slice Spiral CT Angiography in Diagnosing Arterial Diseases of the Lower Extremities

Objective To assess the role and its tecnhique superiority of 64-slice spiral CT angiography(CTA) in lower limb arterial diseases.Methods MSCT studies in 33 cases suspected diseases of lower limb arteries was performed,the helical scans covered the extent of renal artery to the artery of the lower extremity.3D reconstruction of vessel was done in Wizard workstation.The manifestations of MSCTA were compared with that of conventional angiography . Results Of the 693 segments of arteria , 683 were assessable on both DSA and CTA.Using the DSA images as the standard reference,the sensitivity,specificity and accuracy of CTA were 97.6%(95% CI,94.9%~100.7%),98.9%(95% CI,98.0%~99.8%),98.7%(95% CI,97.9%~99.5%)in detecting the segments occluded . With the regard the detection of segments that had more than moderate stenosis , the sensitivity , specificity and accuracy of MIP were 98.9% ( 95% CI , 97.4%~100.4%),99.4%( 95% CI, 98.7%~100.1%) and 99.3%(95% CI, 92.4%~99.9%).Conclusion In assessment of diseases of lower limb arteries with 64-slice spiral CT angiography is equal to DSA basically, it is a highly accurate and non-invasive angiography in diagnosing arterial diseases of the lower extremities.