CT和MR血管成像诊断下肢动脉硬化性闭塞症的临床价值

Clinical value of CT angiography and MR angiography in the diagnosis of arteriosclerotic occlusive disease of lower limb

目的 探讨CT和MR血管成像对下肢动脉硬化性闭塞症动脉狭窄的显示能力和诊断价值.方法 38例下肢动脉硬化患者均行下肢动脉CT血管成像（CTA）和三维增强磁共振血管成像（3D CE-MRA）检查,其中22例同时行数字减影血管造影（DSA）检查.分析不同影像方法 对血管狭窄的显示情况.结果 以DSA为标准,对于动脉完全闭塞,CTA、MRA诊断的敏感度、特异性分别为97.3%,99.1%;100.0%,100.0%.对于管腔达中度狭窄以上的动脉,CTA、MRA诊断的敏感度、特异性分别为99.3%,97.6%;97.9%,96.4%.在管腔达中度狭窄以上的动脉MRA显示狭窄程度比CTA严重（χ2=5.80,P＜0.05）.结论 CTA和3D CE-MRA是下肢动脉硬化性闭塞症的可靠评估方法.

Objective To study the value of CT angiography（CTA） and three dimensional contrast enhanced magnetic resonance angiography（3D CE-MRA） in the diagnosis of arteriosclerotic occlusive disease （ASO） of lower limb and evaluate arterial stenosis. Methods Thirty-eight patients clinically suspected ASO were studied with CTA and3D CE-MRA,twenty-two patients underwent DSA at the same time. The degree of seriousness of the stenosis shown by various imaging techniques were analyzed respectively. Results Using the DSA images as the standard reference, the sensitivity and specificity of CTA were 97.3% ,99. 1%, and MRA both were 100.0% in detecting the segments occluded. With regard the detection of segments that had more than moderate stenosis ,the sensitivity and specificity of CT were 99.3% ,97.6% ,and MRA were 97.9% ,96.4%. The degree of seriousness of the stenosis shown by MRA was overestimated than CTA on the segments that had more than moderate stenosis（x2 =5.80,P ＜0. 05）. Conclusion CTA and 3D CE-MRA were reliable method in diagnosis of ASO.