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目的探讨64层螺旋CT血管成像术在下肢动脉疾病中的应用价值及技术优势。方法对33例疑有下肢动脉疾病患者行64层螺旋CT增强扫描,扫描范围从肾动脉水平达足底。薄层重建横断面图像传入Wizard工作站,进行血管三维重建。结合常规血管造影评价64层螺旋CT血管成像术(CTA)的准确性。结果在693个动脉节段中,683个节段在CTA与DSA均可以显示。以DSA图像为标准,对于动脉完全闭塞,CTA诊断的敏感度、特异性、准确性分别为97.6%(95%CI,94.9%~100.7%)、98.9%(95%CI,98.0%~99.8%)、98.7%(95%CI,97.9%~99.5%)。CTA显示中度以上狭窄的敏感性、特异性及准确性分别为98.9%(95%CI,97.4%~100.4%)、99.4%(95%CI,98.7%~100.1%)、99.3%(95%CI,92.4%~99.9%)。结论64层CT血管成像在评估下肢动脉疾病方面与常规血管造影结果无明显差别,是下肢动脉疾病理想的影像学检查手段。
Objective To explore the value and technical advantages of 64-slice spiral CT angiography in the lower extremity arterial disease. Methods Thirty-three patients with suspected arterial disease of lower extremity underwent 64-slice spiral CT contrast-enhanced scan from the renal artery to the plantar floor. The reconstructed slice images are sent to the Wizard workstation for 3D reconstruction of the vessel. Combined with conventional angiography 64-slice spiral CT angiography (CTA) accuracy. Results Among the 693 arteries, 683 segments were found in both CTA and DSA. The sensitivity, specificity and accuracy of CTA in the diagnosis of complete arterial occlusion were 97.6% (95% CI, 94.9% ~ 100.7%), 98.9% (95% CI, 98.0% ~ 99.8% ), 98.7% (95% CI, 97.9% ~ 99.5%). The sensitivity, specificity and accuracy of CTA for moderate to severe stenosis were 98.9% (95% CI, 97.4% -100.4%), 99.4% (95% CI 98.7% -100.1%), 99.3% CI, 92.4% ~ 99.9%). Conclusion 64-slice CT angiography has no significant difference with conventional angiography in assessing arterial disease of the lower extremities. It is an ideal imaging examination method of arterial disease of the lower extremities.