动脉粥样硬化性肾动脉狭窄的SCTA与DSA对比研究

Evaluation of atherosclerotic renal artery stenosis by spiral CT angiography and digital subtraction angiography

目的:探讨无创性检查螺旋CT血管成像(SCTA)对动脉粥样硬化性肾动脉狭窄(ARAS)的必要性和可靠性。资料和方法:选取57例曾做过DSA肾动脉造影的ARAS患者,行肾动脉SCTA检查,将所获得的图像数据进行MPR、MIP、VR和SSD,并对几种后处理技术进行初步对比,最后将结果与DSA进行对比分析。结果:①各种后处理成像技术中,MIP既能清晰显示肾动脉的解剖学形态,又能清晰显示不同病灶;VR能完整显示肾动脉的解剖学形态,在发现副肾动脉和对重叠血管的显示方面优于MIP,但不能显示血管腔内情况。②SCTA发现狭窄血管76支,其中66支经DSA证实(10支假阳性),符合率为87%,假阳性13%。结论:各种后处理技术中MIP、VR在诊断ARAS中是最有价值的成像技术。SCTA是筛选ARAS的可靠方法并可取代DSA作为首选检查方法。

Objective： To study the reliability and necessity of spiral computed tomography angiography（SCTA） for non-invasive examination of patients with atherosclerotic renal artery stenosis （ARAS）. Materials and Methods： Fifty-seven patients with ARAS were performed with SCTA and intraarterial digital subtraction angiography （DSA）. The materials were analyzed in MPR, MIP, VR, SSD with spiral CT at certain condition and compared with DSA at last. Results： In all the imaging postprocessing techniques, MIP not only can clearly display the anatomy but display the different configurations. VR can display the artery figures but can not display the information of lumen of blood vessels. They shared all advantages. SCTA visualized 76 renal artery stenosis. On DSA, 66 of these stenosis were detected（10 were false-positive cases）. Conclusions： SCTA is helpful to accurately display the renal artery variation and lesions. Both MIP and VR are the best choice to illustrate arterial abnormabties. SCTA is a reliable and accurate screening modabty for the evaluation of patients with ARAS.