摘要
目的探讨256层螺旋CT血管成像在2型糖尿病(T2DM)患者下肢血管病变诊断中的应用价值。方法选取2014年3月至2017年3月期间临床怀疑下肢血管病变的T2DM患者50例为研究对象,利用PHILIPS 256i CT进行全下肢动脉血管成像扫描,将所有获得的数据传入后处理工作站进行图像重建,包括容积再现(VR)、最大密度投影(MIP)、多平面重建(MPR)及曲面重建(CPR),利用智能血管分析和目测法分析血管狭窄程度。结果50例患者的CTA检查均获得清晰的血管重建图像,共显示血管813段,满足诊断要求;50例患者中,正常3例,腹主动脉及下肢动脉粥样硬化36例,胫后动脉痉挛2例,腘动脉远端血栓形成2例,下肢动脉闭塞血管再植后血栓形成2例,多发性动脉瘤1例,左胫前动脉脉管炎3例,外伤后下肢腘动脉离断1例;813段动脉节段中,256层螺旋CT可评估血管756段(92.99%),其中32段有脂质纤维性斑块,724段显示有混合性斑块,不可评估动57段(7.01%),均为钙化斑块;下肢动脉狭窄分级Ⅰ级193段(23.74%),Ⅱ级259段(31.86%),Ⅲ级262段(32.23%),Ⅳ级48段(5.90%),Ⅴ级51段(6.27%)。结论256层螺旋CT血管成像对于T2DM患者下肢血管病变诊断具有很高的准确性,可以有效确定病变性质及范围,为临床治疗方案的选择提供了可靠依据。
Objective To explore the application value of 256-slice spiral CT angiography in diagnosing vascular lesions of lower limbs in patients with type 2 diabetes mellitus(T2DM).Methods 50 T2DM patients clinically suspected with vascular lesions of lower limbs from March 2014 to March 2017 were enrolled in the study.The entire lower limbs arterial angiography scan was performed by PHILIPS256 i CT.All obtained data were transmitted to post-processing workstation to conduct image reconstruction,including volume rendering(VR),maximum intensity projection(MIP),multiplanar reconstruction(MPR)and curve planar reformation(CPR).The intelligent vascular analysis and ocular estimate method were performed to analyze the degree of vascular stenosis.Results The clear vascular reconstruction images by CTA examinations were obtained in all 50 patients.813 segments of blood vessels were displayed,meeting diagnostic requirements.In the 50 patients,there were 3 cases in normal status,36 cases with the abdominal aorta and lower limbs atherosclerosis,2 cases with a spasm of posterior tibial artery,2 cases with thrombosis of distal popliteal artery,2 cases with thrombosis after vascular replantation of lower limbs arterial occlusion,1 case with multiple aneu rysms,3 cases with angiitis of left anterior tibial artery,1 case with the dividing of lower limbs popliteal artery after tra u ma.In the 813 segments of the a rterial segments,756(92.99%)segments of vessels could be assessed by 256-slice spiral CT.There were 32 segments that with lipid fiber plaques,724 segments with mixed plaques.There were 57(7.01%)segments could not be assessed,and all were calcified plaques.There were 193(23.74%)segments with arterial stenosis grading of lower limbs at gradeⅠ,259(31.86%)segments at gradeⅡ,262(32.23%)segments at gradeⅢ,48(5.90%)segments at gradeⅣ,and 51(6.27%)segments at grade V.Conclusion The diagnostic accuracy of 256-slice spiral CT angiography is very high for vascular lesions of lower limbs in T2DM patients,which can effectively determ
作者
郑月月
柳德学
石小霞
ZHENG Yue-yue;LIU De-xue;SHI Xiao-xia(Department of Endocrinology,Nanyang Medical College First Affiliated Hospital,Nanyang 473058,Henan Province,China)
出处
《中国CT和MRI杂志》
2021年第4期174-176,共3页
Chinese Journal of CT and MRI
