摘要
目的：探讨多层螺旋CT血管造影（MSCTA）在下肢动脉疾病诊断中的临床应用价值。材料与方法：对43例临床疑似下肢动脉病变的病人行MSCTA检查，扫描范围自肾动脉水平至踝关节，全长1000～1200mm，层厚2.5mm，螺距1.35～1.675，重建层厚1.25mm，对比剂总量100～120ml，注射速率3.0～3.5ml/s。图像重建方法包括MIP、VR和MPR，其中7例在MSCTA检查前后两周内进行了DSA检查；以DSA所显示的血管正常和狭窄闭塞程度为标准，比较7例130个节段DSA与MSCTA结果，分别数出MSCTA与DSA在各节段狭窄与闭塞的数目，计算出MSCTA诊断下肢动脉狭窄与闭塞的灵敏度与特异度。结果：43例被检查者图像显示清晰，下肢动脉MSCTA重建效果好；以DSA为标准，MSCTA诊断下肢动脉狭窄与闭塞的灵敏度为96.7%，特异度为95.7%，阳性预测值为95.2%，阴性预测值为97.1%，应用Kappa一致性检验法对MSCTA及DSA两种独立方法的评价结果进行统计学处理：K=0.91。结论：MSCTA是一种微创、准确性很高的成像技术，其空间分辨率高、成像速度快、并发症低，在下肢动脉性疾病的诊断中，灵敏度和特异度均很高，具有较高的临床应用价值，在很大程度上可替代DSA检查，有望成为下肢动脉性疾病诊断的首要检查方法。
Abstract
Objective: To evaluate the clinical application of multislice spiral CT angiography(MSCTA) in diagnosing arterial diseases of the lower limb. Materials and Methods: MSCTA was performed in 43 cases suspected of arterial diseases of the lower limb. The spiral scans cover renal artery to the artery of the lower extremity, length of scanning 1000～1200mm, slice thickness 2.5mm, pitch 1.35～1.675, slice increment 1.25mm, the volume of contrast agent 100～120ml, flow rate 3.0～3.5ml/s. The method of reconstruction images included MIP, VR and MPR. Conventional digital subtraction angiography(DSA) was performed in 7 patients within 2 weeks before and after performance of MSCTA. The data of DSA and MSCTA in 130 segments with stenosis and occlusion were calculated. The sensitivity and specificity of MSCTA were calculated using DSA as the standard. Results: Forty-three cases suspected to have arterial diseases of lower limb were demonstrated successfully with MSCTA, and the quality of reconstruction images is satisfactory. Using DSA as the standard reference, the sensitivity, specificity, positive predictive value and negative predictive value of MSCTA were 96.7%, 95.7%, 95.2%, 97.1%, respectively in diagnosing stenosis and occlusion of lower limb artery. Kappa statistical analysis was used to compare the results between MSCTA and DSA(K=0.91). Conclusion: As a non-invasive, high accurate, fast-acquisition, high space resolution, low-complication technique for vascular imaging, MSCTA has a higher sensitivity, specificity and clinical application value in diagnosing arterial diseases of the lower extremities and can replace DSA to a certain extent, MSCTA can become a primary method in diagnosing arterial diseases of the lower extremities.
关键词
动脉 /
下肢 /
体层摄影术 /
螺旋计算机
Key words
Arteries /
Lower extremity /
Tomography /
spiral computed
陈小荣;邹 松.
多层螺旋CT血管造影在下肢动脉疾病中的临床应用[J]. 中国临床医学影像杂志. 2008, 19(3): 193-197
CHEN Xiao-rong;ZOU Song.
Clinical application of multislice spiral CT angiography in lower extremity arterial diseases[J]. Journal of China Clinic Medical Imaging. 2008, 19(3): 193-197
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