新双源CT在下肢动脉阻塞性疾病中的临床应用  

The Clinical Application of New Dual-source CT (DSCT)in Diagnosis of Lower Extremity Arterial Occlusive Disease

作　　者：黄蓉[1] 顾建平[1] 殷信道[1] 楼文胜[1] 何旭[1] 陈亮[1] 陈国平[1] 

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)放射科,江苏南京210006

出　　处：《中国CT和MRI杂志》2013年第2期101-105,共5页Chinese Journal of CT and MRI

摘　　要：目的通过对双源CT血管成像和数字减影血管造影进行比较，评估双源CT血管造影在诊断下肢动脉闭塞性疾病中的临床应用价值。材料与方法对39例疑有下肢动脉硬化性疾病的患者行双源CT增强扫描与DSA检查。扫描范围为双侧肾动脉至足底，将动脉按解剖学分成24个节段：肾下主动脉，左右髂总动脉、髂外动脉、髂内动脉、股总动脉、股浅动脉、股深动脉、胴动脉、胫前动脉、胫腓干、胫后动脉、腓动脉、足背动脉。狭窄程度分级：1级（无狭窄或狭窄程度〈10％）：2级（狭笮程度10％49％）：3级（狭窄程度5O％99％）：4级（完全闭塞）。2位放射科医师独立完成诊断，然后使用CohenK检验进行统计分析。以DSA作为参考标；住，对诊断一致性、敏感性、特异性和狭窄部位的检出准确率进行计算。结果所有痛例的诊断一致性完全符合。DSA中，975段血管中检出病变节段403段。双源CTA的敏感性、特异性和；住确性分别为：94．53％、93．85％及94．11％。结论双源CT血管成像用于评估下肢动脉硬化性疾病是非常一致而又准确的。Objective To evaluate clinical application value of dual-source CT angiography in the diagnosis of lower extremity arterial occlusive disease by comparing dual-source CT angiography （DSCTA） with digital subtraction angiography （DSA）. Methods 39 patients with peripheral arterial occlusive disease were evaluated with dual-source CT angiography and DSA. Arteries depicted at CT angiography and DSA were separated as 24 anatomic segments （infrarenal aorta, right and left common lilac artery, internal iliac artery, external iliac artery, common femoral artery, superficial femoral artery, deep femoral artery, popliteal artery, anterior tibial artery, tibioperoneal trunk, posterior tibial artery, peroneal artery, and dorsum pedis artery）. Graded according to the stenosis degree as follows： class 1 （no stenosis or stenosis 〈10%）; class 2 （stenosis from 10% to 49%）; class 3（stenosis from 50% to 99%）; class 4（complete occlusion）. Two readers independently interpreted the images, and the results underwent Cohen K test. The diagnostic consistency, sensitivity, specificity, and accuracy for the detection of stenotic lesions were calculated, and DSA was used as reference standard. Results The diagnostic consistency was totally corresponded. 403 diseased segments were found among the evaluated 975 segments in DSA. The sensitivity, specificity, and accuracy of dual-source CTA were 94.53%, 93.85%, and 94.11%, respectively. Conclusion Dual-source CT angiography is consistent and accurate in the assessment of lower extremity arterial occlusive disease.

关 键 词：动脉阻塞性疾病 双源CT 血 管成像 

分 类 号：R543.5[医药卫生—心血管疾病] R814.42[医药卫生—内科学]