多层螺旋CT血管造影诊断下肢动脉硬化闭塞症的临床价值

Diagnotsic value of multislice computed tomography angiography in lower extremity arteriosclerosis obliterans

目的:探讨多层螺旋CT血管造影(MSCTA)及三维重建对下肢动脉硬化闭塞症(LEASO)的诊断价值和MSCTA定量测量血管对临床治疗的指导意义。方法:对98例临床确诊或拟诊为LEASO的患者进行MSCTA检查,其中20例患者于MSCTA检查前后2周内进行了数字减影血管造影(DSA)。MSCTA扫描横断面轴位图像应用三维重建技术作图像后处理,每段病变动脉的狭窄程度由GE AW 4.3工作站AVA软件自动测量。结果:MSCTA影像判断LEASO患者病变动脉狭窄程度与DSA的符合率为87.8%。其中判断血管正常(1级)的符合率为91.0%,判断血管狭窄≥70%(4级、5级)的符合率为89.8%。结论:以DSA为金标准,MSCTA评估LEASO患者病变动脉狭窄≥70%有较高的准确性,对LEASO患者制订最佳治疗方案具有重要临床价值。

Objective：To discuss the diagnostic value of multislice computed tomography angiography（MSCTA） with 3D reformation in lower extremity arteriosclerosis obliterans （LEASO） and the value of quantitative vascular measurements with MSCTA for clinical treatment. Methods：A total of 98 patients with known or suspected LEASO were studied by MSCTA. 20 patients also underwent digital subtraction angiography （DSA） within two weeks of MSCrA. Post - processing of image data including 3D reformation was performed after axial images were obtained. The degree of vascular stenosis were analyzed by AVA software of GE AW 4.3work station. Results：When DSA ss gold standard,the overall conformable rate to detect artery stenosis in LEASO by MSCTA was 87.8% .The conformable rate to identify normal artery （1 grade） and 〉170% stenosis（4 grade,5 grade）were 91.0% and 89.8% ,respectively. Conclusion：When DSA ss gold standard, MSCTA permits the visusliation of significant artery stenoses≥ 70% in LEASO with high accuracy. MSCTA shows an important clinical value for LEASO.