双能CTA在下肢动脉阻塞性疾病中的应用价值-第三军医大学学报.doc

下肢双能CTA应用价值的研究：与DSA比较 郝永1，宋云龙2，弥龙3，刘侠3，王东2，孟利民2 第三军医大学，重庆，400038 目的 利用双能去骨方法与传统去骨方法相比较，研究双能CTA对下肢动脉阻塞性疾病诊断的准确性。资料与方法 36例疑患有下肢动脉阻塞性疾病的患者进行了了下肢双能CTA检查，并进行了DSA检查。CTA数据用两种方法进行处理：双能去骨方法及传统自动去骨方法，所有数据皆用MIP图像进行评价，两种方法去骨时间皆被记录。每侧下肢血管被分成7个节段并与DSA进行比较。结果 总共对363个血管节段进行了分析，与金标准DSA进行比较，双能去骨方法的敏感度、特异度、准确度基本达到了90%以上，而传统自动去骨方法以上各数值皆明显下降。结论 双能CTA重建所得MIP图像在评估下肢动脉阻塞性疾病方面与DSA有非常好的一致性, 特别是在小腿部血管，较之传统自动去骨方法得到的MIP图像更加可靠。双能下肢CTA是下肢动脉阻塞性疾病的一种可靠的、准确性高的影像学诊断方法。 关键词 下肢动脉；双能CT；数字减影血管造影；最大密度投影 The Studying of the clinical value of dual-energy computed tomography angiography in lower extremity ：Comparison with DSA HAO Yong, SONG Yunlong, MI Long，LIU Xia, WANG Dong, LI Xiangsheng, MENG Limin, FANG Hong, ZHU Hongxian The 3th Legionary Medical College, Chongqing, Objective To study the accuracy of dual-energy computed tomographic angiography (DE-CTA) for the assessment of symptomatic peripheral arterial occlusive disease of the lower extremity by using the dual-energy bone removal technique compared with a commercially available conventional bone removal tool. Methods 36 patients being doubt of lower limb artery diseases were scanned by dual energy CT and underwent selective digital subtraction angiography. CTA data were postprocessed with two different modes: conventional bone removal and dual-energy bone removal. All data were reconstructed and evaluated as maximum intensity projections. Operator time for bone removal was measured. The vessels in every cases segements wese divided into 7 segements, The accuracy of CTA and conventional digital subtraction angiography was compared. Results A total of 363 vascular segments were analyzed. Compared with digital subtraction angiography, sensitivity, specificity, and accuracy, respectively, of CTA was 90% by the dual-energy bone removal technique, whereas the conventional bone removal technique showed a substantial decrease of sensitivity, specificity, and accuracy. Conclusion There is an excellent agreement in detecting peripheral arterial obstructi