16层螺旋CT在下肢动脉闭塞性疾病中的应用价值

目的:探讨16层螺旋CT血管成像术在诊断下肢动脉闭塞性疾病中的应用价值。方法:对42例临床疑为外周动脉闭塞性疾病的患者行下肢动脉16层螺旋CT血管造影(CTA),扫描范围从肾动脉水平达足底。薄层重建横断面图像传入HP xw8000工作站,进行血管三维重建。所有患者于CTA检查前或后2周内行数字减影血管造影(DSA)。以DSA为金标准,评价CTA诊断的准确性。结果:在882个动脉节段中,870个节段在CTA与DSA均可以显示,在DSA图像上,狭窄闭塞的节段共260个(轻度狭窄32段,中度狭窄24段,重度狭窄44段,闭塞160段),最大密度投影(MIP)显示中度以上狭窄的敏感性、特异性及准确性分别为99.1%、99.7%、99.5%。结论:16层螺旋CT在评估下肢动脉闭塞性疾病方面与常规血管造影结果无明显差别,是下肢动脉闭塞性疾病理想的影像学检查手段,可部分替代DSA检查。

Value of 16-slice spiral CT in lower extremity arterial occlusive diseases

Objective:To explore the diagnostic value of 16-slice spiral CT in assessing the lower extremity arterial occlusive diseases.Methods: Thirty patients with suspected peripheral arterial occlusive diseases underwent 16-slice spiral CT angiography(CTA).The coverage was from renal artery to ankle.We used HP xw8000 workstation for 3D image process.All these patients also underwent digital subtraction angiography(DSA) two weeks before or after CTA.Using the results of DSA as the standard,the diagnostic accuracy of CTA was evaluated.Results: Of the 882 segments,870 were assessable on both DSA and CTA.On DSA images,260 segments were involved(32 mild stenosis,24 moderate stenosis,44 severe stenosis and 160 occlusion).With regard to segments that had more than moderate stenosis,the sensitivity,specificity and accuracy of MIP were 99.1%,99.7%,99.5%.Conclusion: 16-slice spiral CT is high sensitivity,specificity,and accuracy in detecting lower extremity arterial occlusive diseases and may partially substitute DSA examinations.