下肢动脉硬化闭塞症的MSCTA的诊断价值.docVIP

下肢 400037） 摘要：目的 探讨下肢例下肢和手术MIP、VR、MPR和CTVE重建。结果：48例下肢 与DSA和手术结果比较敏感性特异性准确性％。下肢下肢Diagnostic value of Multi-slice CT angiography in the arteriosclerotic occlusive disease of lower limb Qi Yue-yong, Zou Li-guang, Yu Shi-yong,Mu Qiong-ying，SUN Qing-rong (Department of Radiology，Xinqiao Hospital, Third Military Medical University, Chongqing 400037) Abstract：Objective：To assess the clinical value of Multi-slice CT angiography (MSCTA) in the arteriosclerotic occlusive disease of lower limb. Methods：42 cases clinically suspected as the arteriosclerotic occlusive disease of lower limb underwent MSCTA，DSA and/or surgical therapy were analyzed retrospectively. All reconstructed images were reformed by means of MIP, VR, MPR and CTVE. Results：The 48 patients were diagnosed correctly using MSCTA.Compared by DSA and/or 作者简介：戚跃勇，男，重庆市人，硕士，副主任医师，副教授，主要从事CT图像后处理研究。电话（023通信作者：邹利光，电话（023surgical result, sensitivity was 100％ specificity 100％ and accurate rate ％．The multiplanar reconstruction (MPR) images of MSCTA，including mild stenosisin 3, moderate stenosis in 8, severe stenosis in 15, occlusion in 21. Plaques and endoscopic views of stenosis were delineated in MSCTA and CTVE. Conclusion：MSCTA is an accurate method for the assessment of the stenosis and plaques of the arteriosclerotic occlusive disease of lower limb, and served as pre-surgery evaluation and primary method. Key words：artery of lower limb; tomography,X-ray computer; multislice spiral CT; 3-D reconstruction 动脉硬化闭塞症(arteriosclerotic occlusive disease)是由动脉硬化引起的全身性疾病,临床上以下肢动脉硬化闭塞多见，其主要发病机制为内膜损伤、脂质浸润和平滑肌细胞增生等，主要临床表现为间歇性跛行、静息痛和肢体坏疽。数字减影血管造影(DSA)一直是其诊断血管病变的金标准[1]。近年来无创的多排螺旋CT血管成像(multi-slice CT angiography,MSCTA) 已在临床上较广泛地开展，本研究拟探讨MSCTA在下肢MSCT成像方法[1-3]。 1 资料与方法 1.1 一般资料 本研究收集我院2004年1月1日到2008年1月1日期间临床诊断为下肢例,肢体皮肤温度减低,间歇性跛行等。仔细询问病史，排除碘剂禁忌证，向患者解释检查过程，以取得其充分配合。 1.2 方法 运用美国GE Light-Speed 16 型16层螺旋CT 成像系统，患者取仰卧位足先进，踝后垫棉垫使下肢与躯干保持同一水平，将患者的双腿固定，嘱咐患者扫描过程中制动。应用Smartprep技术实时监控，阈值设为120 Hu，通常以腹主动脉分叉以上作为预扫描和诊断扫描的起始层面