40层螺旋CT血管成像在下肢闭塞性动脉硬化症诊断中的应用价值

目的探讨40层螺旋CT血管成像(40-slice computedtomographic angiography,CTA)在下肢闭塞性动脉硬化症(arterioscleroticocclusive disease,ASO)诊断中的价值。方法对临床可疑下肢ASO的27例患者行CT血管成像检查,将数据在Lenonado工作站行容积再现(volume rendering,VR)、最大密度投影(maximum intensity projection,MIP)、曲面重建(curved planar reformation,CPR)及多平面重建(Multiplanar reformation,MPR)等多种后处理并结合原始图像进行综合分析。结果 27例432支血管中均存在以下不同程度的狭窄或闭塞,0级55支,Ⅰ级103支,Ⅱ级104支,Ⅲ级96支,Ⅳ级74支,下肢Ⅲ级以上狭窄最多发生在胫前动脉。9例患者术中所见与CTA一致。结论 40层螺旋CT血管成像可以清晰显示ASO的下肢动脉病变,了解下肢动脉狭窄程度及闭塞情况,对下肢动脉硬化性闭塞性病变的术前明确诊断和筛选治疗方案有很大的帮助。

Applied value of 40-slice CT angiography for diagnosing lower extremity arteriosclerotic-occlusive disease

Objective To evaluate the utility of 40-slice CT angiography（CTA） for diagnosing lower extremity arteriosclerotic-occlusive disease（LEASOD）.Methods Twenty-seven patients with suspected LEASOD underwent CTA examinations.The source images were transferred into Lenonado workstation and postprocessed by using volume rendering（VR）,maximum intensity projection（MIP）,curved planar reconstruction（CPR） and multiplanar reconstruction（MPR）.All data acquired from above reconstruction techniques were comprehensively analyzed together with the source images.Results According to the severity of LEASOD,the assessable 432 vessels in 27 patients were classified as grade 0（n=55）,gradeⅠ（n=103）,gradeⅡ（n=104）,gradeⅢ（n=96）,and gradvⅣ（n=74）.The vessels with stenosis of gradeⅢor over mostly occurred in pretibial arteries.The intraopetive findings in 9 patients were correspondent to CTA findings.Conclusion CTA can clearly show the lesions of LEASOD and can accurately identify the severity of vessel stenosis and occlusion so that it is helpful to perform preoperatively definitive diagnosis and to select optimal therapy protocol.