16层螺旋CT血管造影在下肢动脉成像中的初步应用.docVIP

16层螺旋CT血管造影在下肢动脉成像中的初步应用 孙明华 王韶颖 林涛 余强 范新东 [摘要] 目的 探讨16层螺旋CT血管造影技术（CT angiography，CTA）诊断下肢动脉病变的价值及技术特点。方法 对44例临床疑下肢动脉病变的病人行螺旋CT下肢动脉增强扫描，扫描范围1100－1200mm，层厚2.5-5mm，螺距1.375-1.75，重建层厚1.25mm，重叠50%。对比剂量120-150ml，注射速率2.5-3ml/s，Smartprep自动触发扫描，扫描时间24-35s。对全部重建图像行MIP，VR重建，并对图像进行评价。其中6例同期进行了DSA检查，8例行手术治疗。结果 44例可疑下肢动脉病变患者的下肢动脉在CTA上得以清晰显示。其中下肢动脉硬化性闭塞36例，动静脉畸形2例，髂总动脉瘤1例，腹主动脉瘤2例，3例未见异常。在下肢动脉硬化性闭塞的36例中，肾动脉以下腹主动脉狭窄7例，闭塞2例； 髂总动脉狭窄5例，闭塞4例；髂内外动脉狭窄7例，闭塞7例；股动脉狭窄14例，闭塞19例；腘动脉狭窄5例，闭塞12例；小腿动脉狭窄17例，闭塞20例。29例显示管壁钙化。与DSA和手术结果比较的15例中，敏感性92.9%, 特异性100%, 准确性92.9%。结论 16层螺旋CT血管造影能较好地显示下肢动脉及其病变，可以成为下肢动脉病变术前评价和筛选的主要方法。 [关键词] 下肢动脉 体层摄影术 X线计算机 血管造影术 The application of CTA on lesion of artery of lower limb with 16 -slice spiral CT SUN Minghua，HUANG Shaoying，LIN Tao，YU Qiang，FAN Xindong. Department of Radiology，No.9 People,s Hospital，Shanghai Second Medical University，Shanghai 200011 [Abstract] Objective To evaluate the technical superiority of 16-slice spiral CT angiography on the lesion of artery of lower limb. Method 44 cases with lesion in artery of lower limb diagnosed clinically were performed enhanced 16-slice spiral CT. Slice width 1100-1200mm, slice thickness 2.5-5mm, pitch 1.375-1.75，slice increment 1.25 mm，overlap 50%, the volume of contrast agent 120-150ml, flow rate 2.5-3ml/s. Scan with Smartprep auto-trigger. All scan time 24-35s. All reconstructed images were reformed by means of MIP、VR and evaluated. DSA 6 cases and surgical exposition served as control group 8 cases. Results 44 cases doubtfully with disease in artery of lower limb were demonstrated successfully with CTA. The diagnosis included stiffened occlusion 36 cases, arteriovenous malformation (AVM) 2 cases, iliac communis aneurysm 1 case, femoralis aneurysm 2 cases, normal vessel 3 cases . The stiffened occlusion group were comprised of stenosis 7 cases and occlusion 2 cases in aorta abdominalis below renalis, stenosis 5 cases and occlusion 4 cases in a.iliaca communis, stenosis 7 cases and occlusion 7 cases in a. iliaca int