Barwon Medical Imaging, Geelong Hospital, Ryrie Street, Geelong, Victoria 3226, Australia.
Postgrad Med J. 2011 Mar;87(1025):189-98. doi: 10.1136/pgmj.2009.082040. Epub 2011 Jan 27.
Peripheral arterial disease is usually secondary to stenotic or occlusive atherosclerosis and is both common and increasing in western society. The majority of symptomatic patients have intermittent claudication and only a minority (<2% and typically those with diabetes mellitus or renal failure) progress to critical limb ischaemia, heralded by the onset of rest pain and/or tissue loss. Imaging is largely reserved for patients with disabling symptoms in whom revascularisation is planned. In these patients, accurate depiction of the vascular anatomy is critical for clinical decision making as the distribution and severity of disease are key factors determining whether revascularisation should be by endovascular techniques or open surgery. Driven by advances in technology, non-invasive vascular imaging has recently undergone significant refinement and has replaced conventional digital subtraction angiography for many clinical indications. In this review, the relative merits and limitations of duplex ultrasound, CT angiography, and magnetic resonance angiography are discussed, emerging imaging techniques are described, and complications relating to the use of intravascular contrast agents are highlighted.
外周动脉疾病通常继发于狭窄或闭塞性动脉粥样硬化，在西方社会中较为常见且呈上升趋势。大多数有症状的患者有间歇性跛行，只有少数（<2%，通常是糖尿病或肾衰竭患者）进展为严重肢体缺血，表现为静息痛和/或组织丧失。影像学检查主要用于有症状且计划进行血运重建的患者。在这些患者中，准确描述血管解剖结构对于临床决策至关重要，因为疾病的分布和严重程度是决定是否应采用血管内技术或开放手术进行血运重建的关键因素。随着技术的进步，非侵入性血管成像最近得到了显著改进，并已取代传统的数字减影血管造影用于许多临床适应证。在这篇综述中，讨论了双功能超声、CT 血管造影和磁共振血管造影的优缺点，描述了新兴的成像技术，并强调了与使用血管内造影剂相关的并发症。
