下肢动脉64排螺旋CT血管造影技术及临床应用(附85例分析)

Clinical application and technique of 64-slice spiral CT angiography of lower limb arteries

目的探讨下肢动脉64层螺旋CT血管造影(64-MSCTA)技术及方法,评价其临床应用价值。方法85例临床疑有下肢动脉病变患者行64-MSCTA检查,扫描范围下腹部至足尖,层厚1.25 mm,螺距1.375。采用自动触发扫描技术完成扫描。三维成像方法包括容积再现(VR)、最大密度投影(MIP)、多平面重建(MPR)及高级血管分析(AVA)等。评价成像技术对图像的影响,分析及讨论其诊断结果。结果85例患者中,下肢动脉硬化闭塞症72例,急性血栓形成3例,下肢动脉瘤2例,基本正常8例。下肢动脉病变征像包括软硬斑块、狭窄、闭塞、扩张、侧支循环及血栓形成。其中12例进行手术治疗,10例行DSA检查,所见与64-MSCTA一致。结论64-MSCTA检查技术显示下肢动脉结构、病变清楚,诊断准确率高。该技术将成为诊断下肢动脉疾患及评估手术疗效的首选影像学检查方法。

Objective To discuss the technology of 64-slice spiral CT angiography （64-MSCTA）, and evaluate their clinical application in lower exrremiry arteries. Methods Eighty-five patients with clinically suspected lower extremity arterial disease, were examined by 64-MSCTA with scan range from the lower abdomen to toe, thickness of 1.25 mm. pitch of 1. 375. Automated bolus triggering technology was used. Three dimensional imaging methods include VR, MIP, MPR, AVA, their imaging equality and diagnosis were analyzed and discussed. Results Of 85 patients, there are 72 cases with arterioscle-rotic occlusive disease of lower limb, 3 with acute thrombosis, 2 with lower extremity aneurysms, 8 without abnormal. Signs of lower extremity arterial disease were shown by 64-MSCTA, including soft and hard plaque, stenosis, occlusion, dilatation, thrombosis and collateral circulation. 12 cases by surgery and 10 by DSA. Their diagnosis results is the same that of 64 MSC TA. Conclusion Sixty-four-MSCTA can clearly show the structures and lesions of lower extremity arteries. It has a high diagnostic accuracy and will become the prefer imaging examination of diagnosing lower extremity arterial disease and reexamination post-operation.