螺旋CT血管成像在下肢动脉支架植入术后复查中的应用价值  

The application of spiral CT angiography in postoperative re-examination of lower limb artery stent implantation

作　　者：张宏伟[1,2] 陈家祥[2] 王书智[1] 马跃虎[1] 张娣[1] 姜亮[1] 胡蓝月[1] 顾建平[1] 

机构地区：[1]南京医科大学附属南京市第一医院医学影像科,210006 [2]安徽省马鞍山市中心医院影像中心

出　　处：《介入放射学杂志》2014年第10期878-882,共5页Journal of Interventional Radiology

摘　　要：目的：探讨螺旋CT血管成像在下肢动脉支架植入术后复查中的应用价值。方法对南京市第一医院67例下肢动脉硬化闭塞症支架植入术后患者（共78条患肢、85枚支架）行下肢动脉CTA检查，采用容积再现（VR）、最大密度投影（MIP）、多平面重建（MPR）和曲面重建（CPR）4种血管重建技术，并结合患者临床症状及部分DSA检查结果进行对比分析。结果65例患者（81枚支架）顺利完成检查得出清晰图像，其中43枚支架无狭窄，32枚支架内不同程度狭窄（2-4级），6枚支架闭塞。检查结果与患肢临床症状存在相关性。31例患者（34枚支架）与2周内的DSA造影相比较，3枚支架狭窄程度与DSA判断不同，以DSA为标准，符合率为91.2%。结论下肢动脉CTA检查安全、无创、显影清晰，能够较为准确的反映患肢在治疗后的支架通畅情况，在下肢动脉硬化闭塞症术后复查中具有较好的应用价值。Objective To discuss the application of spiral CT angiography in postoperative re-examination of lower limb artery stent implantation. Methods During the period from March 2012 to March 2014 at the Affiliated Nanjing Hospital of Nanjing Medical University, CT angiography was carried out in 67 patients who had received stent implantation for arteriosclerotic occlusion of lower limb. The diseases involved 78 lower limbs, and a total of 85 stents were employed. The volume rendering （VR）, maximum intensity projection （MIP）, multi-planar reformation （MPR） and curved surface reconstruction （CSR） were performed to stereoscopically display the lesion’s anatomy as well as the implanted stents, and the imaging manifestations were compared with the clinical symptoms and DSA findings. Results Successful examination was accomplished in 65 patients （81 stents in total）, and clear images were obtained. Of the 81 stents, no stenosis was seen in 43, Ⅱ - Ⅳ grade stenosis in 32 and complete occlusion in 6. The results were closely correlated with the clinical symptoms. The CT angiography manifestations in 31 patients （34 stents in total） were compared with their DSA performed in two weeks, and the results showed that the stenotic degrees of three stents judged by CT angiography were not consistent with those judged by DSA. The consistent rate of CT angiography was 91.2% when taking DSA as the standard. Conclusion Lower limb arterial CT angiography examination is a safe and non-invasive technique, it can clearly display the stent inner canal. Therefore, this technique is of great value in postoperative re- examination of lower limb artery stent implantation.

关 键 词：下肢动脉支架 计算机体层摄影 踝臂指数 最大密度投影 多平面重建 曲面重建 容积重现 

分 类 号：R816.2[医药卫生—放射医学] R543.5[医药卫生—临床医学]