128层螺旋CT血管成像在周围动脉闭塞性疾病诊断中的临床应用价值研究  

Application of 128 MDCT Angiography in Lower Extremity Peripheral Arterial Occlusive Disease

作　　者：宋留存 李香芬[1] 陆普选[2] SONG Liu-cun;LI Xiang-fen;LU Pu-xuan(The Sixth People＇s Hospital of Zhengzhou City,Zhengzhou 450015,Henan Province,China)

机构地区：[1]河南省郑州市第六人民医院,河南郑州450015 [2]深圳市第三人民医院,广东深圳518100

出　　处：《中国CT和MRI杂志》2018年第8期145-148,共4页Chinese Journal of CT and MRI

摘　　要：目的评价128层螺旋CT血管成像在周围动脉闭塞性疾病诊断中的临床应用价值。方法前瞻性获取21例下肢动脉闭塞性疾病患者(42侧肢体),平均年龄(71±12.7)岁,获得知情同意后在东芝Aquilion One 128层螺旋CT上进行下肢动脉CTA检查(造影剂:碘帕醇370mg I/m L(Iopamidol,BRACCO),双相注射,造影剂剂量按体重分组),原始图像经过VR、MIP、CPR后处理后获得重建图像。其中有12例共12侧下肢在CTA检查后1周内行DSA检查。由两位有经验的放射科医生共同分析评价CTA显示双下肢各支动脉段图像质量情况及各段狭窄程度,并与DSA比较。结果 21例患者均顺利完成双下肢动脉CTA检查,图像显示度评分为(2.86±0.351)分,CTA静脉重叠评分为(0.14±0.467)分,共有38侧下肢CTA未发生静脉污染,占90.48%(38/42);4侧下肢CTA发生不同程度的静脉强化,占9.53%(4/42)。以DSA为金标准,CTA显示动脉正常及轻度狭窄的敏感性96.30%,特异性98.04%,阳性预测值98.73%,阴性预测值94.33%。结论 128层螺旋CT能够全面清晰显示双下肢动脉病变,为疾病诊断提供快速、有效且可靠的诊断手段,对临床诊断和治疗具有重要指导意义。Objective To evaluate the diagnostic value of 128-MDCT angiography inperipheral arterial occlusive disease. Methods Prospective for 21 patients with lower extremity artery occlusive disease（42 side body）, average age（71±12.7）, and obtain informed consent in Toshiba Aquilion One 128 layer spiral CT on lower limb arterial CTA（contrast agents： iodine 370 mgi palmer alcohol/m L（Iopamidol, BRACCO）, bipolar, injection contrast medium dose groups by weight）, the original image through VR, MIP, CPR image post-processing after reconstruction. A total of 12 patients with 12 lower limbs underwent DSA examination within 1 week after CTA examination. Two experienced radiologists were employed to analyze and evaluate the image quality and stenosis degree of each artery segment of the lower limb shown by CTA, and compared with DSA. Results 21 patients were successfully completed the double lower limb artery CTA examination, image display score was（2.86±0.351）, CTA venous overlap score was（0.14±0.467）points, a total of 38 lower limb venous CTA without pollution, accounting for 90.48%（38/42）. 4 lower limbs CTA of different degrees of venous enhancement, accounted for 9.53%（4/42）. With DSA as the gold standard, CTA showed normal artery mild stenosis and a sensitivity of 96.30%, specificity of 98.04%, positive predictive value of 98.73%, negative predictive value of 94.33% showed obvious stenosis. Conclusion 128-MDCT can clearly show lower extremity arterial disease with important imformation for clinical diagnosis and treatment planning.

关 键 词：周围动脉闭塞性疾病 CT血管成像 128层螺旋CT 

分 类 号：R322.12[医药卫生—人体解剖和组织胚胎学]