| 袁飞,刘银社,董少义,赵军,冯凯琳.64层螺旋CT对下肢动脉硬化闭塞症的诊断价值[J].中国医学影像技术,2008,24(11):1767~1770 |
| 64层螺旋CT对下肢动脉硬化闭塞症的诊断价值 |
| Diagnostic value of 64-slice computed tomography angiography for peripheral arterial occlusive diseases |
| 投稿时间：2008-04-11 修订日期：2008-07-22 |
| DOI： |
| 中文关键词: 体层摄影术, X线计算机 血管造影术,数字减影 外周血管病变 |
| 英文关键词:Tomography, X-ray computed Angiography, digital subtraction Peripheral vascular diseases |
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| 中文摘要: |
| 目的 探讨64层螺旋CT血管造影(64-SCTA)对下肢动脉硬化闭塞症 (PAOD)的诊断价值。 方法 对28例临床怀疑下肢动脉硬化闭塞症的患者行64-SCTA检查,并进行多种方式的图像三维重组,将每例每侧下肢动脉分为11个节段,分析各段血管的显影质量和狭窄程度,以DSA诊断结果为参考标准,评估64-SCTA诊断下肢动脉狭窄的效度。 结果 所有CTA和DSA图像均有诊断价值。其中CTA的动脉显影质量(3.9±0.4)明显好于DSA(3.4±0.5,P<0.008)。64-SCTA显示97.4%血管的狭窄闭塞程度与DSA一致,1%血管的狭窄程度被低估1个级别,1.3%被高估了1个级别,0.3%被高估了2个级别。64-SCTA诊断有血流动力学意义的下肢动脉狭窄(≥50%)的敏感性为99.6％,特异性为99.7%,准确度98.7%,阳性预测值为99.6％,阴性预测值为99.7％。 结论 64-SCTA可无创、准确地诊断PAOD,为治疗方案的制定及术后随访提供依据。 |
| 英文摘要: |
| Objective To investigate the diagnostic value of 64-slice computed tomography angiography (64-SCTA) for peripheral arterial occlusive disease (PAOD). Methods 64-SCTA scanning was performed in 28 patients suspected of PAOD. CT data sets were transferred to workstation for imaging post-processing, including VR, MIP, CPR and vessel analysis. DSA was used as the reference standard. The common iliac arteries, the external iliac arteries, the internal iliac arteries, the common femoral arteries, the deep femoral arteries, the superficial femoral arteries, the popliteal arteries, the tibiofibular trunks, the anterior tibial arteries, the peroneal arteries, the posterior tibial arteries were assessed on the right and the left sides separately. All arterial segments were analyzed with regard to image quality and stenosis grade. The sensitivity, specificity, positive and negative predictive values and accuracy for determination of significant arterial stenosis were calculated for all 22 segments together. Results All DSA and CTA studies were considered to be diagnostically conclusive. Rating of arterial visibility was significantly better with 64-SCTA techniques than that of DSA(P<0.008). In all 64-SCTA findings, 97.4% was consistent with conventional DSA, 1% of arterial stenosis was underestimated 1 grade, 1.3% of arterial stenosis was overestimated 1 grade, 0.3% was overestimated 2 grade. Compared with conventional DSA, the sensitivity, specificity, accuracy, positive predictive value, negative predictive value of 64-SCTA with regard to detection of hemodynamically significant stenosis (≥50%) in all 28 patients were 99.6％, 99.7%, 98.7%, 99.6％ and 99.7％, respectively. Conclusion 64-SCTA is an accurate and reliable noninvasive means to identify PAOD, and is also useful for therapeutic planning and postoperative follow-up. |
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