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目的:探讨锁骨下-上肢动脉狭窄及闭塞的CT血管成像(CTA)检查技术及临床价值。方法:36例锁骨下-上肢动脉狭窄及闭塞的患者行MSCTA检查,分析其检查技术、病变征象及CT诊断价值。结果:36例中血栓形成11例、动脉硬化13例、大动脉炎12例。36例均成功完成CTA检查,靶血管显示清楚。曲面重组(CPR)及横轴面图像可同时观察血管腔及管壁,急性血栓6例,在横轴面及CPR图像上密度低于亚急性和慢性血栓(5例)。最大密度投影(MIP)显示侧支血管最佳(23例),13例动脉硬化横轴面及容积再现(VR)图像均显示血管壁钙化。CTA还能显示13例动脉硬化及12例大动脉炎患者其他部位的血管病变。结论:锁骨下-上肢动脉MSCTA可清楚显示动脉狭窄或闭塞的部位及特征,应作为本病的常规检查方法,多种后处理技术的联合使用对诊断也有重要作用。
Objective: To investigate the technique and clinical value of CT angiography (CTA) in subclavian-upper extremity arterial stenosis and occlusion. Methods: Thirty-six patients with subclavian-upper extremity arterial stenosis and occlusion were examined by MSCTA. The diagnostic techniques, signs of lesion and CT diagnosis were analyzed. Results: Among 36 cases, thrombosis occurred in 11 cases, arteriosclerosis in 13 cases and arteritis in 12 cases. 36 cases were successfully completed CTA examination, the target vessel showed clearly. Surface reconstruction (CPR) and transverse axial images were observed in 6 cases of acute vascular thrombosis and vascular wall at the same time. The densities were lower in the transverse and CPR images than in the subacute and chronic thrombi (5 cases). The maximum density projection (MIP) showed that the collateral vessels were the best (23 cases), and 13 cases of atherosclerosis lateralization and volume rendering (VR) images showed vascular calcification. CTA also showed vascular lesions in 13 patients with arteriosclerosis and in 12 other patients with arteritis. Conclusion: The subclavian-upper extremity artery MSCTA can clearly show the location and characteristics of arterial stenosis or occlusion. It should be used as a routine examination method for this disease. The combination of various post-treatment techniques also plays an important role in the diagnosis.