64排螺旋CT血管造影对下肢缺血性疾病侧支循环的诊断价值

The diagnostic value of collateral circulation secondary to lower limb ischemia using 64-detector helical computed tomography angiography

目的探讨64排螺旋CT血管造影(CTA)显示下肢缺血性疾病侧支循环的影像表现及临床价值。方法 27例下肢动脉狭窄、闭塞后丰富侧支循环形成的患者纳入本研究,将重建图像的原始数据传输到ADW4.4工作站,行容积再现(VR)、最大密度投影(MIP)、曲面重建(CPR)等多种后处理,同时结合原始图像进行分析。结果 27例患者中,22例下肢动脉多处节段性狭窄、闭塞,5例为下肢动脉单处闭塞。下肢CTA显示,下肢动脉局段狭窄、闭塞后,肢体远端主要通过腹部与盆腔的动脉吻合支、髋周围动脉网、膝关节动脉网、小腿肌群动脉侧支及吻合网等进行血供代偿。结论 64排螺旋CT血管造影对下肢缺血性疾病的主要侧支循环显示满意,为临床治疗方案的制定及术后随访提供可靠的依据。

Objective To discuss 64-detector helical CT angiography finding and Clinical Value of collateral circulation secondary to lower limb ischemia. Methods Twenty-seven patients with collateral circulation secondary to lower limb ischemia by 64-detector helical CTA were collected. The data was transmitted to ADW4.4 workstation and reconstructed by volume rendering（VR）,maximum intensity projection（MIP） and curved planar reconstruction（CPR）,then combined with axial images to analyze. Results Twenty-two cases were with multi-segmental occlusion of artery of lower extremity while 5 cases were simple. CTA displayed the blood flow of lower extremity compensated by anas-tomotic branch between abdominal arteries and pelviartery,vessel network around hip joint,vessel network around knee joint and the arterial branches of crural muscle groups. Conclusion 64-detector helical CTA demonstrated satisfactorily the primary collateral circulation of lower limb ischemia,potentially providing a reliable evidence for thera-peutic planning and postoperative follow-up.