64层螺旋CT血管成像对下肢动脉闭塞性病变的临床诊断价值

摘要

Objective To assess the value of 64-Slices spiral CTA with DSA comparatively in diagnosis of lower extremity arterial oc-clusive disease .Methods CTA was used to examine 48 patients with clinically suspected lower extremity arterial occlusive disease .A-mong the 48 patients,29 patients also underwent DSA examination within one week .CT was performed with scan range from 1 000 mm to 1 200 mm,thickness of 6 mm,pitch of 0.8,reconstruction thickness of 1 mm.Dosage of contrast agent was 1.5 mL· kg-1 and the in-jection rate was 4.5 mL· s-1.All images were reconstructed by multi-planar reformation (MPR),volume rendering (VR),maximum intensity projection ( MIP) in working-station respectively .Lower limb angiography was inspected subsectly by DSA .CTA and DSA data of 29 patients were compared with each other .Results DSA was taken as the gold standard to evaluate the diagnosis accuracy of CTA . The sensitivity,specificity of lower extremity arterial stenosis (vessel stenosis≥50%) were 92.5% (161/174) and 97.1% (103/106) respectively.CTA and DSA were shown no obvious difference in the diagnosis of lower extremity artery occlusive disease (χ2 =0. 385,P=0.984).Conclusions The arterial occlusive diseases in the lower extremity can be well shown by 64-slice spiral CTA,which is a reliable method for evaluating the lower extremity arterial occlusive disease .%目的：对照数字血管减影（ DSA），探讨64层螺旋CT血管成像对下肢动脉闭塞性病变的临床诊断价值。方法对48例临床疑有下肢动脉闭塞性疾病的患者行CT血管成像（ CTA）检查。其中29例于检查后1周内行DSA检查。 CT扫描范围1000～1200 mm，层厚6 mm，螺距0．8，重建层厚1 mm，对比剂用量1．5 mL· kg-1，注射速率4～5 mL· s-1。 CT薄层重建数据发送至工作站进行MPR，VR及MIP重建技术，DSA采用分段进行下肢动脉造影检查。将接受两种检查方法的29例患者的CTA与DSA相同血管节段进行比较。结果以DSA为金标准，CTA诊断下肢动脉狭窄（≥50％）的灵敏度及特异度分别为92．5％（161/174）、97．1％（103/106），χ2值0．385，P值为0．984＞0．05，说明CTA诊断下肢血管狭窄与DSA结果无明显差别。结论64层螺旋CT血管造影能清晰显示下肢动脉及其病变，是下肢动脉狭窄硬化性疾病的可靠评估方法。