CAJ | 학술논문

目的探讨下肢动脉闭塞性疾病采用64层CT血管成像时,在腘动脉行小剂量对比剂试验的意义.方法连续选取28例临床怀疑下肢动脉闭塞性疾病患者,应用64层CT在两侧腘动脉(膝关节层面)各设置一ROI进行小剂量对比剂试验,明确显示峰值及达峰时间者认为曲线获取成功.分析两侧腘动脉峰值、达峰时间、左右两侧的差异,及其对下肢动脉CTA的影响,并采用Pearson相关法分析达峰时间与峰值的相关性.根据达峰时间采用快速模式启动扫描,并将图像质量分为优、良、差3个级别按节段进行评价,计算优和良的动脉节段数占总节段数的百分比即优良率.结果 28例患者中获取腘动脉小剂量对比剂曲线的成功率为96%(54/56).26例获得双侧小剂量对比剂曲线的患者中,腘动脉峰值及达峰时间差异较大,分别为60～178(135±28)HU,21～46(31±6)s.左右腘动脉峰值及达峰时间差异亦较大,19例左右峰值不一致,差值10～80 HU,平均(32±18)HU;21例左右达峰时间不一致,差值1～12 s,平均(5±3)s.达峰时间与峰值呈负相关(r= -0.526,P<0.01).下肢CTA 616个动脉节段中,成像质量优598个,良12个,优良率为99%(610/616).结论下肢动脉闭塞性疾病采用64层CT血管成像时,应用腘动脉小剂量对比剂试验可以准确把握扫描时机,从而获得良好的血管成像质量.
목적 탐토하지동맥폐새성질병채용64층CT혈관성상시,재객동맥행소제량대비제시험적의의.방법 련속선취28례림상부의하지동맥폐새성질병환자,응용64층CT재량측객동맥(슬관절층면)각설치일ROI진행소제량대비제시험,명학현시봉치급체봉시간자인위곡선획취성공.분석량측객동맥봉치、체봉시간、좌우량측적차이,급기대하지동맥CTA적영향,병채용Pearson상관법분석체봉시간여봉치적상관성.근거체봉시간채용쾌속모식계동소묘,병장도상질량분위우、량、차3개급별안절단진행평개,계산우화량적동맥절단수점총절단수적백분비즉우량솔.결과 28례환자중획취객동맥소제량대비제곡선적성공솔위96%(54/56).26례획득쌍측소제량대비제곡선적환자중,객동맥봉치급체봉시간차이교대,분별위60～178(135±28)HU,21～46(31±6)s.좌우객동맥봉치급체봉시간차이역교대,19례좌우봉치불일치,차치10～80 HU,평균(32±18)HU;21례좌우체봉시간불일치,차치1～12 s,평균(5±3)s.체봉시간여봉치정부상관(r= -0.526,P<0.01).하지CTA 616개동맥절단중,성상질량우598개,량12개,우량솔위99%(610/616).결론 하지동맥폐새성질병채용64층CT혈관성상시,응용객동맥소제량대비제시험가이준학파악소묘시궤,종이획득량호적혈관성상질량.
Objective To investigate the clinical value of the test injection at popliteal arteries on 64-slice CTA in lower extremity peripheral arterial occlusive disease (PAOD). Methods Twenty-eight patients with PAOD referred for 64-slice CTA were enrolled consecutively in the study. Test injection was performed at bilateral popliteal arteries (the level of knee joints) and the clinic value of the peak value and the time to peak was analyzed. The relationship between the time to peak and the peak value was evaluated with Pearson test. The time to peak was used for programming of the CT angiographic acquisitions with fast scanning mode. The quality of visualization of each arterial segment was determined independently by two radiologists. Results Fifty-four (96%, 54/56) time-attenuation curves were obtained in 28 patients. The wide interindividual variation in the peak value and the time to peak was observed in 52 curves of 26 patients with range of 60-178 HU,21-46 s and an average of (135±28) HU,(31±6) s, respectively. The difference in the peak value and the time to peak between bilateral popliteal arteries was also observed with range of 10-80 HU and an average of (32±18) HU in 19 patients,with range of 1-12 s and an average of (5±3) s in 21 patients. There was negative relationship between the peak value and the time to peak (r=-0.526, P<0.01). The CTA images were of good (598 segments) or medium quality (12 segments) in 99% segments (610/616). Conclusions The test injection at popliteal arteries was useful for 64-slice CTA in the patients with PAOD, as it could accurately specify the delay time of CT angiographic acquisitions.