Ishigami Kousei, Yoshimitsu Kengo, Irie Hiroyuki, Tajima Tsuyoshi, Asayama Yoshiki, Hirakawa Masakazu, Honda Hiroshi
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, Fukuoka 812-8582, Japan.
AJR Am J Roentgenol. 2006 Oct;187(4):1002-9. doi: 10.2214/AJR.05.1114.
The objective of our study was to evaluate the diagnostic accuracy of MDCT and conventional angiography in the detection of an accessory left gastric artery using CT hepatic arteriography as the standard of reference.
The study group consisted of 118 patients who underwent MDCT with a triple-phase liver protocol with a slice thickness of 5 mm, conventional angiography, and CT hepatic arteriography. The early-phase images of MDCT and conventional angiography were retrospectively reviewed. The presence or absence of an accessory left gastric artery was evaluated using CT hepatic arteriography as the standard of reference. The sensitivity, specificity, and accuracy of MDCT and conventional angiography were calculated.
CT hepatic arteriography revealed an accessory left gastric artery in 25 (21.2%) of 118 cases, including 15 proximal- and 10 distal-type accessory left gastric arteries. On MDCT, there were seven false-negative cases and one false-positive case. Six of the seven false-negative cases were a proximal-type accessory left gastric artery, and nine of 10 distal-type accessory left gastric arteries were correctly diagnosed using MDCT. The sensitivity, specificity, and accuracy of MDCT were 72.0%, 98.9%, and 93.2%, respectively. On conventional angiography, there were three false-negative and two false-positive cases, none of whom underwent selective left hepatic arteriography. Two of the three false-negative cases were the distal-type accessory left gastric artery, but eight of the 10 distal-type accessory left gastric arteries were correctly diagnosed. The sensitivity, specificity, and accuracy of conventional angiography were 88.0%, 97.8%, and 95.8%, respectively.
Approximately 70% of accessory left gastric arteries can be diagnosed at the early phase of MDCT even with a slice thickness of 5 mm.
本研究的目的是以CT肝动脉造影作为参考标准，评估多层螺旋CT（MDCT）和传统血管造影在检测副左胃动脉方面的诊断准确性。
研究组由118例患者组成，这些患者接受了层厚为5mm的肝脏三期MDCT扫描、传统血管造影以及CT肝动脉造影。对MDCT和传统血管造影的早期图像进行回顾性分析。以CT肝动脉造影作为参考标准，评估副左胃动脉的有无。计算MDCT和传统血管造影的敏感性、特异性和准确性。
CT肝动脉造影显示118例中有25例（21.2%）存在副左胃动脉，其中包括15例近端型和10例远端型副左胃动脉。在MDCT上，有7例假阴性病例和1例假阳性病例。7例假阴性病例中有6例为近端型副左胃动脉，10例远端型副左胃动脉中有9例通过MDCT被正确诊断。MDCT的敏感性、特异性和准确性分别为72.0%、98.9%和93.2%。在传统血管造影上，有3例假阴性和2例假阳性病例，这些病例均未进行选择性左肝动脉造影。3例假阴性病例中有2例为远端型副左胃动脉，但10例远端型副左胃动脉中有8例被正确诊断。传统血管造影的敏感性、特异性和准确性分别为88.0%、97.8%和95.8%。
即使层厚为5mm，MDCT早期也能诊断出约70%的副左胃动脉。
