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目的研究64层螺旋CT血管成像在下肢动脉损伤诊断中的应用价值及误诊漏诊原因。方法回顾性分析30例下肢动脉损伤的下肢动脉多层螺旋CT血管成像(MSCTA)图像,运用各种图像后处理技术分析动脉损伤情况,并与数字减影血管造影(DSA)或手术探查结果对比。结果 30例患者中有动脉闭塞36处,动脉断裂14处,动脉狭窄52处,假性动脉瘤10处,动静脉瘘4处。MSCTA诊断下肢动脉损伤的结果与DSA或手术探查结果对比,诊断符合率为94.78%。结论 MSCTA可直观、准确地显示下肢动脉损伤情况。各种后处理技术中,MPR/CPR对下肢动脉损伤显示最佳,VR对手术定位有很好的辅助作用。
Objective To investigate the value of 64-slice spiral CT angiography in the diagnosis of arterial injury of the lower extremities and the causes of misdiagnosis and missed diagnosis. Methods Thirty cases of lower extremity arterial multi-slice spiral CT angiography (MSCTA) were retrospectively analyzed. Arterial damage was analyzed using various post-processing techniques and compared with digital subtraction angiography (DSA) or surgical exploration results . Results Among the 30 patients, there were 36 arterial occlusions, 14 arterial ruptures, 52 arterial stenoses, 10 pseudoaneurysms and 4 arteriovenous fistulas. MSCTA diagnosis of lower extremity arterial injury results compared with DSA or surgical exploration, the diagnostic coincidence rate was 94.78%. Conclusion MSCTA can directly and accurately show the lower extremity arterial injury. In various post-treatment techniques, MPR / CPR shows the best arterial injury in the lower extremities, and VR plays a good role in the surgical localization.