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目的探讨多层螺旋CT血管造影(MSCTA)诊断锁骨下动脉狭窄的价值。方法临床怀疑锁骨下动脉狭窄引起的锁骨下动脉窃血综合征10例患者行MSCTA检查,对比剂使用碘海醇80～90ml,流速3～4ml/s,采用Surestar技术跟踪扫描,阈值140～160HU。图像后处理:扫描后将图像薄层1mm重建,将图像数据传至工作站,分别行容积重组(VR)、多平面重组(MPR)及曲面重组(CPR)。以左侧椎动脉分出处为界,将左侧锁骨下动脉分为近侧段和远侧段。结果狭窄位置:近侧6例、远侧4例;局限性狭窄6例,多发性狭窄4例,总狭窄部位14个;狭窄范围0.8～2.0cm,其中≤1cm10例,1.1～2.0cm4例;管腔狭窄程度≤50%7例、9部位,50%～70%3例、5部位。与DSA检查对比,其显示狭窄的部位、范围、程度基本一致。结论MSCTA对诊断锁骨下动脉的狭窄具有重要意义。
Objective To investigate the value of multi-slice spiral CT angiography (MSCTA) in the diagnosis of subclavian artery stenosis. Methods Ten patients undergoing supraclavicular artery steal syndrome caused by subclavian artery stenosis were enrolled in this study. The contrast agent was given 80 ~ 90ml iohexol and the flow rate was 3 ~ 4ml / s. Surestar technique was used to track the lesion. The threshold was 140 ~ 160HU . Image post-processing: After scanning, the image is reconstructed by 1mm thin layer, and the image data is transmitted to the workstation for VR, MPR and CPR respectively. To the left vertebral artery branch as the boundary, the left subclavian artery is divided into proximal and distal segments. Results The location of stenosis was 6 cases in the proximal and 4 cases in the distal. There were 6 cases of localized stenosis, 4 cases of multiple stenosis and 14 cases of total stenosis. The stenosis ranged from 0.8 to 2.0 cm, including 10 cases of ≤1 cm and 1.1 to 2.0 cm in 4 cases. The degree of luminal stenosis ≤50% 7 cases, 9 parts, 50% ~ 70% 3 cases, 5 parts. Compared with the DSA examination, it shows that the site of stenosis, extent and extent are basically the same. Conclusion MSCTA is of great significance for the diagnosis of subclavian artery stenosis.