64层MSCT血管成像对下肢动脉粥样硬化的评价

Evaluating artherosclerosis in lower extremities with 64-slice MSCT angiography

目的:探讨多层螺旋CT血管成像对下肢动脉粥样硬化的诊断价值。方法:选择临床可疑下肢动脉粥样硬化性疾病患者21例作为研究对象,采用GE LightSpeed 64层螺旋CT对全下肢动脉进行CTA扫描,将获得的原始数据传入AW4.2P后处理工作站,血管重建技术包括VR、MIP、MPR及CPR,血管狭窄程度的评估采用智能血管分析与目测法相结合。结果:21例患者共显示血管336段,均获得了清晰的血管重建图像,全部满足诊断要求。除5例患者下肢动脉CTA表现正常外,其余16例均发现不同程度的粥样硬化斑块。336段血管中,7段有脂质纤维性斑块,27段有钙化斑块,222段显示广泛的混合性斑块;其中完全闭塞占4.46%;重度狭窄7.14%;中度狭窄31.8%;轻度狭窄32.7%;无明显狭窄者23.8%。结论:64层MSCT血管成像对下肢动脉粥样硬化的诊断具有很高准确性,各种血管重建技术的联合应用能够提供更多的诊断信息,有助于临床治疗方案的选择。

Objective： To explore the value of multi-slice spiral computed tomography （MSCT） angiography in the diagnosis of artherosclerosis in lower extremities. Methods： CT angiography （CTA） was performed in 21 patients with clinical suspicious artheroscle- rosis in lower extremities by a GE Light Speed 64-slice MSCT scanner. Then the row date was transmitted to the AW 4.2P work station. Source images were processed by post-processing software- the VR, MIP, MPR and CPR techniques. Degree of angiostenosis was evalu- ated by intelligent analysis combined with visual estimation. Results： The CTA clearly demonstrated all 336 segments of lower artery in 21 patients, and all images fit the diagnosing conditions. Except CTA images of 5 patients were normal, all of the remaining l 6 cases had atherosclerotic plaques. In 336 segments of lower artery, 7 segments had lipid-fibrous plaques, 27 segments had calcification plaques and 222 segments had mixed plaques. For the degree of angiostenosis, 4.46 % of the segments were total occlusion, 7.14 % were severe stenosis, 31.8 % were moderate stenosis, 32.7 % were slight sienosis and 23.8 % had no stenosis. Conclusion： 64-slice MSCT angiogra- phy is very accurate for diagnosing artherosclerosis in lower extremities. Association application of several kinds of reconstruction tech- niques could provide more diagnosis information that helps to make choice of treatment plans.