目的探讨64层螺旋CT血管造影在下肢动脉硬化性闭塞症(ASO)的关键成像技术问题及临床应用价值。方法对32例临床拟诊为ASO的患者行64层螺旋CT血管造影检查,将重建图像的原始数据传输到ADW4.2工作站行容积再现(VR)、最大密度投影(MIP)、曲面重建(CPR)及高级血管分析(AVA)等多种后处理,同时结合原始图像进行分析;9例CT血管造影检查后一周内行数字减影血管造影检查(DSA)。结果所有患者下肢动脉图像显示良好,其中正常3例,29例下肢动脉存在节段性管腔狭窄,并在闭塞动脉周围可见较多代偿侧支血管影存在。544个节段血管共有346段0级狭窄,131段Ⅰ级狭窄,33段Ⅱ级狭窄,15段Ⅲ级,19段Ⅳ级狭窄。9例患者数字减影血管造影检查与CT血管造影检查相比,在153个节段血管中的显示符合率为95.4%。结论64层螺旋CT下肢动脉造影检查可清晰地显示病变血管的狭窄程度及管壁斑块,为下肢动脉硬化性闭塞症的筛查、诊断及治疗前的评估提供依据。 Objective To explore the key imaging techniques and clinical application value of 64-slice spiral CT angiography in lower extremity arteriosclerosis obliterans (ASO). Methods 32 patients with suspected ASO were examined by 64-slice spiral CT angiography. The original data of reconstructed images were transmitted to the ADW4.2 workstation for volume displacement reconstruction (VR), maximum density projection (MIP), surface reconstruction (CPR ) And advanced blood vessel analysis (AVA), and combined with the original image analysis; digital subtraction angiography (DSA) within one week after CT angiography. Results All patients showed good images of the lower extremity arteries, of which 3 were normal and 29 had lower extremity arteries with segmental stenosis. More compensatory collateral vessels were seen around the occluded arteries. There were 346 grade 0 stenosis, 54 grade 1 stenosis, 131 grade Ⅰ stenosis, 33 grade Ⅱ stenosis, 15 grade Ⅲ and 19 grade Ⅳ stenosis. Digital subtraction angiography in 9 patients showed 95.4% compliance with the CT angiography in 153 segmental vessels. Conclusion 64-slice spiral CT lower extremity arteriography can clearly show the degree of vascular stenosis and wall plaque, which can provide the basis for the screening, diagnosis and assessment of lower extremity arteriosclerotic occlusive disease.