下肢动脉狭窄闭塞性病变的多排螺旋CT血管成像

The Diagnostic value of Multi-slice CT angiography in the Steno-occlusive Arterial Disease of Lower limb

目的探讨下肢动脉狭窄闭塞性病变的多排螺旋CT血管成像(MSCTA)的诊断价值。方法48例临床怀疑下肢动脉狭窄闭塞性病变患者行MSCTA检查,同时行DSA检查和/或手术治疗,所有MSCTA检查均行MIP、VR、MPR和CTVE重建。结果48例下肢动脉狭窄闭塞性病变的MSCTA均能获得准确的诊断,与DSA和手术结果比较,其敏感性、特异性和准确性均为100%。通过多平面重建测量其面积狭窄百分率,以狭窄程度最严重处为准,表现为轻度狭窄者3例,中度狭窄8例,重度狭窄16例,闭塞21例。MSCT重建技术能显示斑块及狭窄管腔内部形态。结论MSCT血管成像可直观地显示下肢动脉狭窄闭塞性病变的狭窄程度,有利于术前评价。

Objective To assess the clinical value of Multi-slice CT angiography （MSCTA） in the steno-occlusive arterial disease of lower limb. Methods 42 cases clinically suspected as the steno-occlusive arterial disease of lower limb underwent MSCTA; DSA and/or surgical therapy were analyzed retrospectively. All reconstructed images were reformed by means of MIP, VR, MPR and CTVE. Results The 48 patients were diagnosed correctly using MSCTA. Compared by DSA and/ or surgical result, sensitivity was 100 %, specificity 100 % and accurate rate 100 %. The percentage of area stenosis were measured from the multiplanar reconstruction（MPR） images of MSCTA, including mild stenosisin 3, moderate stenosis in 8, severe stenosis in 15, and occlusion in 21. Plaques and endoscopic views of stenosis were delineated in MSCTA and CTVE. Conclusion MSCTA is an accurate method for the assessment of the stenosis and plaques of the steno-occlusive arterial disease of lower limb, and can serve as pre-surgery evaluation and primary method.