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目的:探讨256iCT双下肢血管成像在动脉硬化闭塞症中的临床应用价值。方法:对119例有临床症状的下肢动脉硬化闭塞症患者行256iCT双下肢动脉增强扫描,扫描范围从腹腔干水平到达足底,将薄层轴位原始图像传入EBW工作站,进行血管三维重建。75例患者在行CT扫描后的1～2周内行DSA检查,将256iCT血管图像与DSA图像进行对比分析。结果:在1575个动脉节段中,1505个节段在CTA与DSA均可以显示,以DSA为诊断标准,256iCTA诊断下肢动脉闭塞的的敏感性、特异性、准确性分别为100.0%、98.8%、99.7%;对于显示中度以上狭窄,256iCTA的敏感性、特异性、准确性分别为99.3%、97.8%、98.2%。256iCT血管成像在评估下肢动脉硬化闭塞症与DSA结果一致性非常好(k=0.945)。975处节段性病变中,905处管壁存在管壁粥样斑块,12处为附壁血栓。结论:256iCT下肢血管成像是下肢动脉硬化闭塞症的理想的影像学手段,对临床制定治疗方案有重要的指导价值。
Objective: To investigate the clinical value of 256iCT dual-vessel angiography in arteriosclerosis obliterans. Methods: A total of 119 patients with clinical symptoms of lower extremity arteriosclerosis obliterans underwent 256iCT double lower extremity arterial enhancement scanning. The scanning range was from the celiac level to the plantar floor. The original axial slice images were sent to the EBW workstation for three-dimensional reconstruction of blood vessels. One hundred and twenty-five patients underwent DSA within 1 to 2 weeks after CT scan. The contrast between 256iCT images and DSA images was analyzed. Results: Among 1575 arterial segments, 1505 segments showed both CTA and DSA. The sensitivity, specificity and accuracy of 256iCTA in diagnosis of lower extremity arterial occlusion were 100.0% and 98.8%, respectively, using DSA as diagnostic criteria. , 99.7%. The sensitivity, specificity and accuracy of 256iCTA were 99.3%, 97.8% and 98.2% respectively for those with moderate or severe stenosis. 256iCT angiography was very consistent with DSA in assessing arterial occlusive disease of the lower extremities (k = 0.945). Among the 975 segmental lesions, there were wall plaque at 905 and mural thrombus at 12. Conclusion: 256iCT lower extremity vascular imaging is an ideal imaging method for lower extremity arterial occlusive disease, which has important guiding value for clinical treatment planning.