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目的探讨多层螺旋CT血管成像(MSCTA)在诊断肾血管性高血压的CT表现及临床应用价值。方法搜集临床疑诊为肾血管性高血压的患者57例,均行128层螺旋CT肾动脉CTA及常规肾髓质期、分泌期扫描,15例同时进行肾动脉数字减影血管造影(DSA)检查,分析其CT表现,并将MSCTA与DSA检测结果对比。结果 MSCT共检出肾血管病变28例(检出率49.1%),其中肾动脉狭窄25例(检出率43.9%),肾动脉瘤2例,肾静脉瘤样扩张1例;显示肾动脉斑块69处,肾皮质强化减弱4例;MSCTA与DSA比较,对肾动脉狭窄诊断敏感度、特异度、准确度差异无显著性。结论 MSCTA对肾血管性高血压的筛查及诊断有着无可比拟的优势,在显示肾动脉斑块明显优于DSA。
Objective To investigate the CT findings and clinical value of multislice spiral CT angiography (MSCTA) in the diagnosis of renovascular hypertension. Methods Fifty-seven patients with clinically suspected renal vascular hypertension were enrolled in this study. All patients underwent CTA with 128-slice spiral CT and routine renal medullary and secretory phase scans. Fifteen patients underwent digital subtraction angiography (DSA) The CT findings were examined and analyzed, and the results of MSCTA and DSA were compared. Results MSCT detected renal vascular lesions in 28 cases (detection rate was 49.1%), of which 25 cases of renal artery stenosis (detection rate of 43.9%), 2 cases of renal aneurysm, renal vein aneurysm-like expansion in 1 case; showed renal artery plaque Block 69, renal cortical enhancement decreased in 4 cases; MSCTA compared with DSA, the sensitivity, specificity and accuracy of the diagnosis of renal artery stenosis no significant difference. Conclusion MSCTA has an unparalleled advantage in the screening and diagnosis of renovascular hypertension, showing that renal artery plaque is superior to DSA.