股动脉及腘动脉闭塞部位远端CT值变化及临床意义

OCCLUSION OF FEMORAL ARTERY AND POPLITEAL ARTERY:CHANGES OF CT VALUE DISTAL TO THE SITE OF OCCLUSION AND CLINICAL SIGNIFICANCE

目的通过CT下肢动脉造影与数字减影血管造影(DSA)对比,研究股动脉及腘动脉闭塞性病变远端CT值变化及临床意义。方法股动脉及腘动脉闭塞病人50例,均行CT下肢动脉造影及DSA检查,以DSA为判断标准,统计CT动脉造影反向递减征象和侧支循环在股动脉及腘动脉慢性完全和部分闭塞性病变中的出现率。结果慢性完全闭塞组和部分闭塞组CT值反向递减出现率及周围侧支循环出现率比较,差异有显著性。利用CT值反向递减征象和CT血管造影侧支循环征象诊断股动脉及腘动脉慢性完全闭塞的灵敏度为92%,特异度为71%。结论 CT值反向递减征象对于诊断股动脉及腘动脉慢性完全闭塞具有较高特异性,并且有助于鉴别股动脉及腘动脉慢性部分和完全闭塞情况。

Objective Through CT lower limb artery angiography（ AA） and comparing with DSA,to study the changes of CT value in the distal part of obstruction of femoral artery（ FA） and popliteal artery（ PA） and their clinical significance. Methods Fifty patients with FA and PA obstruction received CT lower limb AA and DSA examination. The frequency of reverse intra-luminal opacification gradient sign and collateral circulations in chronic complete occlusion and partial occlusion of FA and PA was noted and analyzed. Results The differences in frequency of reverse attenuation gradient sign and the occurrence of collate-ral circulation on CT angiography between chronic complete obstruction group and partial obstruction group were significant. Employing reverse attenuation gradient sign and collateral circulation sign to diagnose chronic complete obstruction of FA and PA,the sensibility was 92%,and specificity was 71%. Conclusion The reverse attenuation gradient sign of CT value has a higher specificity in the diagnosis of chronic complete obstruction of femoral artery and popliteal artery,which is helpful in the identification of partial and chronic complete obstruction of the arteries.