16层螺旋CT血管成像对下肢动脉硬化性闭塞症的诊断价值

Diagnostic value of 16-slice spiral CT angiography in arteriosclerotic occlusive disease of lower extremities

目的：探讨16层螺旋CT血管成像（MDCTA）对下肢动脉硬化性闭塞性疾病的诊断价值。方珐：比较25例临床疑有下肢动脉硬化性阻塞性病变患者的16层螺旋CT血管成像与数字减影血管造影（DSA）检查表现。以DSA表现作为金标准，来评估16层螺旋CT血管成像的临床价值。其中，CTA技术采用最大密度投影（MIP）和容积再现（VR）两种后处理方法。结朵：25例病例共263支动脉纳入本研究。其中，DSA发现193支狭窄或闭塞的血管（47支轻度狭窄，12支中度狭窄，20支重度狭窄，114支闭塞）；16层螺旋CTA发现192支狭窄或闭塞的血管（55支轻度狭窄，12支中度狭窄，24支重度狭窄，101支闭塞）。对于腹主动脉至足背动脉间中度及其以上狭窄（50％～100%）的血管，CTA的敏感度、特异度和准确度分别为87．7％、92．3％、89．7％；对于腹主动脉至胭动脉间中度及其以上狭窄（50％-100％）的血管，CTA的敏感度、特异度和准确度分别为92％、91．8％、91．9％。结论：16层螺旋CT血管成像是评估下肢动脉狭窄及闭塞程度的一种可靠的检查方法。

Objective： To evaluate the efficacy of MDCT angiography in the assessment of lower limb peripheral arterial occlusive diseases. Methods： Twenty-five patients with symptomatic lower extremity peripheral arterial occlusive diseases who underwent both MDCT angiography and digital subtraction angiography （DSA） of the aortoiliac and lower extremity arteries were were compared with each other. The clinical value of MDCT collected. And the images of both examination angiography was evaluated, using digital subtraction angiography as the standard reference. Both MIP （maximum-intensity-projection） and VR（volumerendering） were used in reconstruction of CTA. Results： Two hundred and sixty-three arteries in 25 patients were included in this study. On DSA, 193 stenoocclusive segments （47 mildly stenotic, 12 moderately stenotic, 20 severely stenotic, and 114 occluded） were detected. On MDCTA, 192 stenoocclusive segments （55 mildly stenotie, 12 moderately stenotic, 24 severely stenotie, and 101 occluded） were detected. With regard to the detection of segments among lower extremity arteries that had more than mild stenosis, the sensitivity, specificity, and accuracy of MDCT angiography were 87.7%, 92.3%, and 89.7%, respectively. With regard to the detection of segments above the popliteal arteries that had more than mild stenosis, the sensitivity, specificity, and accuracy of MDCT angiography were 92%, 91.8%, and 91.9%, respectively. Conclusion： MDCT angiography is a reliable method for evaluating the aortoiliac and lower extremity arteries.