16层螺旋CT血管成像在下肢血管病变诊断中的应用  

16-MDCT angiography for assessment of lower extremity vascular lesions

作　　者：金启安[1] 邓克学[1] 邓福生[2] 曹东兴[1] 胡何节[2] 

机构地区：[1]安徽医科大学附属省立医院影像科,合肥230001 [2]安徽医科大学附属省立医院血管外科,合肥230001

出　　处：《安徽医科大学学报》2006年第4期459-462,共4页Acta Universitatis Medicinalis Anhui

摘　　要：目的评价16层螺旋CT血管成像在下肢血管病变中的应用价值。方法33例临床怀疑下肢血管病变的患者进行16层螺旋CT扫描，采用增强后容积扫描，层厚1．25mm×16，床速27．5mm／圈，螺距1．375：1，重建层厚1．25mm，重建间隔1．25mm。扫描范围从腹主动脉至足趾，增强延迟时间动脉期为38-42S，静脉期为120～150s。图像传至AW4．2工作站进行图像重建。结果33例下肢血管在VR及MIP成像中，正常7例，腹主动脉及下肢动脉粥样硬化13例，胫后动静脉瘘伴多发静脉瘤1例，多发性动脉瘤2例，外伤后下肢胭动脉离断1例，胫后动脉痉挛1例，下肢动脉闭塞血管再植后血栓形成1例，滑膜肉瘤术后伴股深静脉瘤栓1例，胭动脉远端血栓形成1例，左胫前动脉脉管炎3例，右股骨下段软组织内血管瘤1例（供血动脉来源于股外侧动脉），股动脉穿刺后股动脉前侧血肿机化形成假性动脉瘤1例。结论16层螺旋CT血管成像在下肢血管病变诊断中，可筛选和发现病变，并确定病变性质、范围，可作为临床有效、无创的检查方法。Objective To valuate the clinical value of 16-detector row computed angiography in the diagnosis of lower limb peripheral arterial and venous lesions. Methods 33 patients with suspected lower extremity vascular diseases were examed with 16-MDCT angiography under volume scanner. The scanning parameters are as follows： detector collimation（ 1.25 mm ×16）, table speed（27.5 mm/rot） ,and pitch （ 1. 375 ： 1 ） ,slice thickness and reconstruction interval（ 1.25 mm and 1.25 mm） ;The time delay from injection to scanning was 38 -42 seconds in the arterial phase and 120 -150 seconds in the venous phase. On the basis of patient＇s age and body weight,the contrast dose for extremity MDCT angiography study varies from 100 ml to 150 ml with flow rate of 3 - 3.5 ml/s. Then axial source images were transfered to the ADW4. 2 workstation and volume rendering（VR） and maximum intensity projections（MIP） were obtained. Results VR and MIP findings on 16-MDCT angiography were as follows： normal（7）, abdominal aortic and lower extremity arterial mural calcification （n = 13 ）, AVF of the posterior tibial artery with mutiple angioma（ n = 1 ）, mutiple aneurysms of abdominal aortic and the posterior tibial artery （ n = 2）, posttrumatic dissction of popliteal artery（ n = 1 ）, spasm of the posterior tibial artery （ n = 1 ）, arterial vascular embolus of lower arterial occlusion （ n = 1 ）, tumormbolus of deep femoral vein after operating （ n = 1 ）, embolus of the distal segement of popliteal artery（ n = 1 ）, angitis of anterior tibial artery （n = 3 ）, soft tissue angioma of the lower segement of femoral artery （ n = 1 ）, hematoma organniaziation （ n = 1 ）. Conclusion 16-MDCT angiography has high clinical potential to be used in the diagnosis of lower extremity vascular lesions, which can help screen and define the type, size of the vascular diseases.

关 键 词：血管造影术 体层摄影术 螺旋计算机 下肢/放射摄影术 血管疾病/放射摄影术 

分 类 号：R543[医药卫生—心血管疾病] R816[医药卫生—内科学]