下肢动脉硬化闭塞症16层螺旋CT血管成像分析

The evaluation of lower extremity arterial occlusive disease with 16-slice CT

目的采用16层螺旋CT血管造影(CTA)探讨下肢动脉硬化闭塞症的病变特点。方法对45例经临床确诊的下肢动脉硬化闭塞症患者的图像进行分析。使用16层螺旋CT行下肢动脉CTA检查,将获得的图像送到工作站后处理;对所有图像进行MIP、VR及SSD显示重建,,部分行血管内镜检查;对图像进行分段评价。结果所有病例血管重建图像显示良好,将腹主动脉以下病变分为5型,其中腹主动脉型2例,髂动脉型3例,股腘动脉型16例,小腿动脉型6例,广泛型18例,侧支循环建立13例。病变CTA表现为血管管腔不规则,单发或多发狭窄、闭塞,局部侧支血管形成,部分管壁钙化。所有患者在行CTA结束后24～48 h内行DSA检查;在膝上大动脉(腘动脉及以上血管)病变中,CTA与DSA对病变检出率未见统计学差异(χ2=2.381,P=0.304);在膝下小动脉(胫前动脉发出点及以下血管)未见统计学差异(χ2=0.003,P=0.998)。结论 16层螺旋CT血管造影可以充分而准确地显示下肢动脉硬化闭塞症的病变情况,并可作出合适分型,有明显临床应用价值。

Objective To evaluate the lower extremity arterial occlusive disease with 16-slice CT. Methods A total of 45 patients diagnosed lower extremity arterial occlusive disease with image analysis,and all these patients under went 16- slice CT angiography,to obtain images to the workstation after treatment. All reconstructed inages were reformed by means of MIP,VR,SSD and VE. Results All cases were demonserated successfully with CTA. There were 2 case in aorta abdomi- nal artevy, 3 cases in iliae artery. 16 cases in fenorals and popliteal artery, 6 cases inartery of calf, 18 cases were diffuseive and molesion. The pathological changes in CTA included irregular counter of vascular lumen, single and/or multiple seenos and occlusion. Forming of collaterlization and calcification. All patients in the CTA 24-48 h DSA examination after the end; In the artery above the knee （from the infrarcnal aorta to and including the popliteal artery）,there was no significant difference between CTA and DSA on the detection rate of lesions （X^2=2.381 ,P = 0.304）.In the artery below the knee（from the start of anterior tibial artery to dorsal artery of foot） ,there was no significant difference between CTA and DSA on the detection rate of lesions （X^2=0.003 ,P = 0.998）. Conclusion 16-slice spiral CT angiography can was valuable to demonstrate arteriosclertie occlusive in arter of lower limb and classify it, and may make the appropriate type.