64层螺旋CT后处理技术评价下肢血管损伤

Diagnostic value of 64-slice CT post-processing techniques in lower extremity arterial injury

目的探讨64层螺旋CT后处理技术显示下肢血管损伤的优缺点及应用价值。方法分析行64层螺旋CT血管造影(CTA)检查的下肢血管损伤的30例患者的血管重组图像,比较各种图像后处理技术对下肢动脉损伤的显示效果,30例患者包括16例单纯动脉损伤,10例假性动脉瘤,4例动静脉瘘,其中8例为下肢骨折内固定术后。10例假性动脉瘤患者同时行数字减影动脉造影(DSA)检查及破口修复术,15例单纯动脉损伤经手术证实,其余5例病例经磁共振血管造影(MRA)等检查和随访证实。比较各种图像后处理技术对下肢动脉损伤的显示效果。结果 30例患者CTA都能清晰显示下肢动脉损伤,与原始轴位和MPR/CPR相比,MIP及VR诊断动脉狭窄的准确性分别为70.59%(12/17),58.82%(10/17)。CTA对血管损伤的诊断与DSA、手术所见及MRA等相关检查随访完全相符,但CTA对下肢动脉损伤后血栓形成诊断的准确率为60.71%(17/28)。结论 64层螺旋CTA可准确、直观显示下肢动脉损伤情况。各种下肢血管后处理成像技术中,MPR/CPR结合原始轴位对下肢血管损伤显示最佳,VR对手术定位有很好的辅助作用。

Objective To investigate the diagnostic value of 64-slice spiral CT angiography post-processing techniques in lower extremity arterial injury. Methods 30 patients with lower extremity arterial injury including simple arterial injuries（16）,pseudoaneurysm（10）, and arteriovenous fistula（4） underwent CT angiography with MPR / CPR, MIP and VR reconstruction. The effectiveness of these image post-processing methods was compared. Results All arterial injuries were clearly displayed with accuracy of 70.59%（12 / 17） on MIP and 58.82%（10 / 17） on VR for diagnosing arterial stenosis, 60.71% for diagnosing arterial thrombosis in comparison with axial display and MPR / CPR. Conclusion 64-slice spiral CT angiography can accurately show lower extremity arterial injury. MPR / CPR combined with the axial images was the best post-processing display whereas VR can aidsurgical planning.