下肢动脉64层螺旋CT血管成像方法的探讨  

Methodologic study on 64-slice spiral CT angiography of lower extremity arteries

作　　者：贾慧娟[1] 郭芸[1] 秦雷[1] 魏里[1] 付玉存[1] 

机构地区：[1]山东省聊城市人民医院CT室,山东聊城252000

出　　处：《实用医学影像杂志》2011年第5期308-310,331,共4页Journal of Practical Medical Imaging

摘　　要：目的探讨小剂量团注试验技术在下肢动脉CTA成像中的应用价值。方法 38例临床怀疑周围动脉闭塞性疾病(PAOD)患者均经下肢动脉64层螺旋CTA扫描。其中,触发组18例,采用自动触发扫描技术;试验组20例,采用小剂量(对比剂20 mL)团注试验技术,根据膝关节水平动态扫描峰值时间确定CTA扫描延时点及扫描持续时间。每组CTA图像由2名有经验的影像科医师根据以下3个方面进行评价:(1)VR及断层图像显示最远分支血管的级别;(2)MIP及断层图像显示动脉边缘的光滑度;(3)3级(股浅动脉中段、胫前动脉中段、足背动脉)动脉的CT值,比较2组患者的CTA图像质量并做χ2检验,P值小于0.05可认为是显著性差异。结果股-月国动脉段触发组达标例数15例,不达标例数3例;试验组达标例数16例,不达标例数4例,两组差异无统计学意义(χ2=0.0885,P>0.05)。小腿动脉段触发组达标例数10例,不达标例数8例;试验组达标例数17例,不达标例数3例,两组差异有统计学意义(χ2=5.044,P<0.05)。足背动脉段触发组达标例数8例,不达标例数10例;试验组达标例数15例,不达标例数5例,两组差异有统计学意义(χ2=4.676,P<0.05)。结论小剂量团注试验法较自动触发扫描法在显示下肢膝关节以下动脉图像上更有优势。Objective To study the feasibility of low dose bolus injection test in 64-slice spiral CT angiography（MSCTA） of lower extremity arteries（LEA）.Methods Thirty-eight patients with clinically suspected peripheral arterial occlusive disease（PAOD） underwent MSCTA of LEA.According to different scanning techniques 38 patients were divided into two groups： trigger group（n=18） underwent automatic trigger and test group（n=20） underwent low dose（20 mL of contrast medium） bolus injection.The optimal delay time and durative time of MSCTA scanning were determined by the peak time in dynamic scans on knee level.All images acquired from the both techniques were evaluated by two experienced radiologists for the following three aspects i.e.the most distal segment of LEA showed by VR and axial images;the smooth degree of arterial edge showed by MIP and axial images;and the CT value in three grade arteries which comprised mid-segment of superficial femoral artery,mid-segment of anterior tibia artery and dorsal pedal artery.Statistic analysis for comparing the image quality between two groups was performed with the Chi-square test and a P value less than 0.05 was considered significantly different.Results For the visualization of superficial femoral artery,targeted and non-targeted arteries in trigger group were 15 and 3 cases,respectively,while those in test group were 16 and 4 cases,respectively,there was not significant difference between two groups（χ2=0.0885,P〉0.05）.For the visualization of leg artery,targeted and non-targeted arteries in trigger group were 10 and 8 cases,respectively,while those in test group were 17 and 3 cases,respectively,there was statistic difference between two groups（χ2=5.044,P〈0.05）.For the visualization of dorsal pedal artery,targeted and non-targeted arteries in trigger group were 8 and 10 cases,respectively,while those in test group were 15 and 5 cases,respectively,there was statistic difference between two groups（χ2=4.676,P〈0.05）.Conclusion Scanning modal

关 键 词：下肢动脉 体层摄影术 X线计算机 血管造影术 

分 类 号：R816.2[医药卫生—放射医学]