髂-股动脉多层螺旋CT测量

目的:采用16层螺旋CTA对髂-股动脉进行测量,为经髂-股动脉介入诊疗提供影像学数据。方法:收集2010年6月～9月符合要求的连续病例350例,按照年龄21～40岁、41～60岁、61～89岁分为A、B、C组。经肘正中静脉注射对比剂后,用16层螺旋CT进行包括盆腔区的增强扫描,薄层重建图像用容积再现技术对髂-股动脉进行三维重建。测量动脉分叉到髂嵴连线、股骨头上缘连线的垂直距离及动脉分叉夹角。相同性别不同年龄组间采用单因素方差分析,相同年龄组不同性别采用两独立样本t检验,不同侧别间采用配对样本t检验。结果:腹主动脉分叉、左右髂总动脉分叉、左右股总动脉分叉到股骨头上缘连线的垂直距离男性A组分别为(132.5±12.8)mm、(87.1±14.9)mm、(88.8±11.3)mm、(43.4±13.7)mm、(41.5±15.0)mm,B组为(126.5±11.6)mm、(84.8±14.2)mm、(89.1±12.9)mm、(44.3±10.1)mm、(46.2±10.1)mm,C组为(115.6±10.7)mm、(80.3±14.3)mm、(82.3±13.6)mm、(39.1±10.0)mm、(40.4±10.0)mm,女性A组分别为(135.4±12.1)mm、(91.3±15.1)mm、(97.4±14.1)mm、(36.5±10.3)mm、(36.2±10.3)mm,B组为(129.8±12.7)mm、(92.7±12.5)mm、(96.0±13.3)mm、(36.5±10.8)mm、(35.8±10.9)mm,C组为(121.2±13.1)mm、(84.0±11.3)mm、(86.3±11.4)mm、(36.4±12.2)mm、(36.9±11.0)mm。除男性左髂总动脉分叉、女性左右股总动脉分叉到股骨头上缘连线的垂直距离外,不同年龄组间差异均有统计学意义(P<0.05)。腹主动脉分叉夹角、左右髂总动脉分叉夹角男性A组分别为(38.2±5.8)°、(26.6±16.9)°、(30.5±10.8)°,B组为(38.1±11.3)°、(25.3±10.8)°、(24.8±11.2)°,C组为(45.1±16.5)°、(25.8±12.5)°、(25.6±13.2)°,女性A组分别为(46.9±10.9)°、(28.2±13.5)°、(28.9±10.2)°,B组为(40.7±11.2)°、(20.3±10.3)°、(21.6±9.7)°,C组为(45.1±11.2)°、(21.0±9.9)°、(27.0±12.1)°,男女腹主动脉分叉夹角、男性左右髂总动脉分叉夹角不同年龄组间差异有统计学意义(P<0.05)。两侧对比三组的髂总动脉分叉点至股骨头上缘连线垂直距离差异均有统计学意义(P<0.05)。结论:16层螺旋CTA可对髂-股动脉进行准确测量,为介入诊疗提供数据。

Measurement of iliofemoral artery with multi-slice spiral CT

Objective：To measure rofemoral artery using 16-slice CT angiography （CTA） to offer imaging data for inter- ventional procedure via iliofemoral artery. Methods： From June to September 2010, 350 patients achieving the standard were included. After injecting contrast materials through median cubita! veins, contrast-enhanced scans of pelvis were per- formed by 16-slice spiral CT. After thin-slice reconstruction, the images of iliofemoral arteries were reconstructed into 3D- images with the technique of volume rendering （VR）. Vertical distances from artery bifurcations to inter-lilac-crest line or liner-femoral-head line and angles of artery bifurcation were measured. The differences among age groups were compared by analysis of variance using SPSS 13.0; and the differences between male and female were analyzed by independent-sam- ples t test, and the differences between left and right side were analyzed by paired-samples t test. Results： Vertical dis- tances from abdominal aortic bifurcation （AAB）, left or right common iliac artery bifurcations （CIAB）, left or right com- mon femoral artery bifurcations （CFAB） to inter-femoral-head line of male were （132.5±12.8） ram, （87.1±14.9） ram, （88.8±11.3） ram, （43.4±13.7） mm, （41.5±15.0） mm in group A; and （126.5±11.6） ram, （84.8±14.2） mm, （89.1±12.9） ram, （44.3±10.1） ram, （46.2±10.1） mm in group B; and （115.6±10.7） mm, （80.3±14.3） mm, （82.3±13.6） ram, （39.1±10.0） mm, （40.4±10.0） mm in group C. Those of female were （135.4±12.1） mm, （91.3 ±15.1） ram, （97.4±14.1） ram, （36.5±10.3） mm, （36.5±10.3） mmingroup A; and （129.8±12.7） mm, （92.7±12.5） mm, （96.0±13.3） mm, （36.5±10.8） mm, （35.8±10. 9） mm in group B; and （121. 2±13. 1） ram, （84.0±11.3） mm, （86.3±11.4） mm, （36.4±12.2） ram, （36. 9±11.0） mm in group C. There were significant difference a- mong the age groups （ P 〈0.05） except male left CIAB. femal left and right CFAB to inter-femoral-head line. Angles of AAB, left and right CIAB of male were （38.2±5.8）°, （26.6±16.9）°. （30.5±10.8）°ih group A; and （38. 1±11. 3）°. （25.3±10.8）°, （24.8±11.2）° in group B~ and （45. 1±16.5）°, （25.8±12.5）°, （25.6±13.2）°ingroupC. Those of fe- male were （46.9±10.9）°, （28.2±13.5）°. （28.9±10. 2）° in group A; and （46. 9±10. 9）°, （28.2±13. 5）° （28.9±10.2）° in groupB~ and （45. 1±11.2）°, （21.0±9.9）°, （27.0±12.1） ° in group C. There were significant difference of male and female angles of AAB, male left and right CIAB among the age groups （ P 〈0.05）. Between left and right side there were significant difference of CIAB among the three age groups （ P 〈0.05）. Conelusiong 16-slice CTA can proceed accurate measurement of iliofemoral artery and offer data for interventional procedure.