下肢CTA自拟新注射扫描方案对下肢动脉闭塞性病变的临床诊断价值  

Clinical value of/self-made new injection scanning scheme of lower extremity CTA in the diagnosis of lower extremity arterial occlusive diseases

作　　者：莫广盛 余水全[1] 刘锋[1] 韦彩琴 黄鸣宇[1] MO Guangsheng;YU Shuiquan;LIU Feng;WEI Caiqin;HUANG Mingyu(Department of Radiology,Zhongshan Hospital Affiliated to Guangzhou University of Traditional Chinese Medicine,Zhongshan 528400,Guangdong,China)

机构地区：[1]广州中医药大学附属中山医院医学影像科,广东中山528400

出　　处：《西部医学》2022年第9期1390-1395,共6页Medical Journal of West China

基　　金：中山市医学科研项目(2021A020742)。

摘　　要：目的探讨下肢动脉血管成像(CTA)自拟新注射扫描方案对下肢动脉闭塞性病变(ASO)的临床诊断价值。方法选取2020年1月~2021年6月我院收治的108例疑似下肢ASO患者,按随机数表法分为A、B两组各54例,均采用256层CT行下肢CTA检查,其中A组采用常规注射扫描方案,B组自拟新注射扫描方案(第一期盐水20 mL,流速4.5 mL/s;第二期对比剂30 mL,流速4.5 mL/s;第三期对比剂70 mL,流速3 mL/s;第四期盐水20 mL,流速3.0 mL/s;四期连续无间断注射)。所得图像上传至工作站进行三维重建,比较两组CTA图像质量。由不同资深放射科医师阅片并得出一致诊断结果,以经数字减影血管造影(DSA)结果为金标准,比较两组对ASO的诊断效果。结果B组CTA图像对小腿动脉、足部动脉区域的动脉节段数显影不良率低于A组(0.00%vs 14.81%、1.85%vs 14.81%),静脉显影率1.85%低于A组14.81%(均P<0.05)。B组CTA图像小腿动脉、足部动脉区域的动脉分支、血管边缘显影评分均高于A组(P<0.05)。参照DSA结果,B组CTA图像对下肢血管狭窄程度分级诊断符合率94.44%(51/54)高于A组81.48%(44/54),差异有统计学意义(P<0.05)。B组诊断ASO的敏感度、准确度均高于A组(97.73%vs 82.22%、96.30%vs 83.33%),差异有统计学意义(P<0.05)。结论自拟新注射扫描方案能提高下肢CTA显影效果,减少显影不良和静脉显影干扰,提高下肢CTA图像质量和ASO诊断效能,具有临床推广应用价值。Objective To evaluate the diagnostic value of lower extremity arterial angiography(CTA)in lower extremity arterial occlusive lesions(ASO).Methods A total of 108 suspected lower extremity ASO patients admitted to our hospital from January 2020 to June 2021 were selected and divided into two groups according to the random number table method:Group A and group B,54 cases in each group.All patients underwent lower extremity CTA examination by 256-slice CT.Group B:The co-efficient 20 mL,the total velocity is 4)5 mL/s.The second phase contrast medium was 30 mL,the flow rate was 4.5 mL/s.In the third phase,the contrast medium was 70 mL,and the flow rate was 3 mL/s.The fourth phase was 20 mL saline,with a flow rate of 3)0 mL/s.Four consecutive injections without interruption).The obtained images were uploaded to the workstation for 3D reconstruction,and the image quality of the two groups of CTA was compared.The results of digital subtraction angiography(DSA)were used as the gold standard to compare the diagnostic effect of ASO between the two groups.Results CTA group B image of calf,foot artery areas of segmental arteries imaging defective rate is lower than group A(0.00%1.85%vs 14.81%,vs 14.81%),vein enhancement rate 1.85%lower than A set of 14.81%(P<0.05).Group B CTA images leg,foot area of the artery artery branches,vascular imaging score were higher than in group A(P<0.05).Reference DSA results,group B CTA images of lower limb vascular stenosis degree grading diagnosis coincidence rate 94.44%(51/54)higher than that of group A,81.48%(44/54),the difference was statistically significant(P<0.05).Sensitivity and accuracy of the diagnosis of ASO B group were higher than in group A(97.73%vs 82.22%,96.30%vs 83.33%),the difference was statistically significant(P<0.05).Conclusion The new self-designed injection scanning scheme can improve the imaging effect of lower extremity CTA,reduce the interference of poor imaging and venous imaging,improve the image quality of lower extremity CTA and the diagnostic efficiency of ASO,whi

关 键 词：动脉硬化疾病 下肢动脉闭塞性病变 下肢动脉血管成像 注射扫描方案 图像质量 

分 类 号：R654.3[医药卫生—外科学]