Medical Imaging, University Health Network, 399 Bathurst St., McLaughlin Pavilion, 3rd Floor Rm 431, Toronto, ON, M5T 2S8, Canada.
Int J Cardiovasc Imaging. 2012 Dec;28(8):2073-83. doi: 10.1007/s10554-011-9978-z.
We examine volumetric CT perfusion in soft tissues of the entire foot with an en bloc technique to provide a meaningful measure of differentiation between mild and major vascular impairment. With Institutional Review Board approval, 22 healthy male subjects between the ages of 21 and 50 (mean 37) were enrolled. Volumetric computed tomography using an en bloc technique was conducted on 14 subjects for validation while unilateral vascular obstruction was simulated in the calves of the remaining 8 subjects. Perfusion estimates were made using in-house software and differences in perfusion estimates between feet were evaluated with Student's t-test at 95% confidence. Subjects with simulated major vascular obstruction (calf blood pressure cuff inflated to 200 mmHg) showed significantly higher ratios of perfusion estimates between the unobstructed and obstructed foot compared to subjects with simulated mild vascular obstruction (cuff inflated to 120 mmHg), mean 4.6, SD 2.6 vs. mean 1.3, SD 0.2; P = 0.05. CT perfusion using an en bloc technique shows promise for the future evaluation of patients with critical limb ischemia and particularly for re-characterization post medical, surgical or endovascular intervention.
我们采用整体技术检查整个足部的容积 CT 灌注，以提供区分轻度和重度血管损伤的有意义的指标。在机构审查委员会的批准下，我们招募了 22 名年龄在 21 岁至 50 岁之间（平均年龄 37 岁）的健康男性受试者。14 名受试者采用整体技术进行容积 CT 检查以进行验证，而其余 8 名受试者的小腿模拟单侧血管阻塞。使用内部软件进行灌注估计，并使用 95%置信区间的学生 t 检验评估双脚之间的灌注估计差异。与模拟轻度血管阻塞（袖带充气至 120mmHg）的受试者相比，模拟重度血管阻塞（袖带充气至 200mmHg）的受试者的未阻塞和阻塞脚之间的灌注估计比值明显更高，平均 4.6，SD 2.6 与平均 1.3，SD 0.2；P = 0.05。整体技术的 CT 灌注技术有望用于未来评估严重肢体缺血患者，特别是用于医疗、手术或血管内干预后的再特征化。
