Di Stasi C, Cina A, Manfredi R, Colafati S
Istituto di Radiologia, Università Cattolica del S. Cuore, Policlinico A. Gemelli, Largo A. Gemelli 8,00168 Roma, Italy.
Rays. 2001 Oct-Dec;26(4):277-89.
At present, there are a number of diagnostic imaging procedures for the evaluation of lower limb atherosclerosis. In particular, MR-angiography with contrast medium and multislice CT are rapidly developing. However, their role in clinical practice is still to be defined. In this article, first, the functional anatomy of peripheral arterial system divided into inflow arteries (aortoiliac trunk), outflow arteries (femoropoplietal trunk) and runoff arteries (leg and foot vessels), is examined. Then, image extraction with color-Doppler US, inflow MR-angiography with contrast material, multislice CT and angiography is briefly illustrated. The corresponding advantages and disadvantages, are indicated. The findings of combined imaging in relation to the various stages of atherosclerosis are analyzed. In particular, intimal thickening leading to occlusion is considered with respect to both morphology and flow alterations. Based on these considerations, the use of the different procedures is discussed in relation to the clinical presentation (no symptoms, claudication or pain, trophic lesions, during postoperative follow-up). For each stage, questions the radiologist should address for a correct approach and the best cost/benefit ratio, are described.
目前，有多种诊断成像程序可用于评估下肢动脉粥样硬化。特别是，使用造影剂的磁共振血管造影和多层CT正在迅速发展。然而，它们在临床实践中的作用仍有待确定。在本文中，首先，对外周动脉系统的功能解剖进行了研究，该系统分为流入动脉（主-髂动脉干）、流出动脉（股-腘动脉干）和终末动脉（小腿和足部血管）。然后，简要说明了彩色多普勒超声图像采集、使用造影剂的流入磁共振血管造影、多层CT和血管造影。指出了相应的优缺点。分析了联合成像与动脉粥样硬化各个阶段相关的结果。特别是，从形态学和血流改变两方面考虑了导致闭塞的内膜增厚。基于这些考虑，针对临床表现（无症状、间歇性跛行或疼痛、营养性病变、术后随访期间）讨论了不同程序的使用。对于每个阶段，描述了放射科医生为正确诊断和获得最佳成本效益比应解决的问题。
