对于患有急性或慢性外周动脉疾病的患者，将动态CT血管造影作为主要诊断成像方式时的诊断信心。

Diagnostic confidence of run-off CT-angiography as the primary diagnostic imaging modality in patients presenting with acute or chronic peripheral arterial disease.

作者信息

Werncke Thomas, Ringe Kristina Imeen, von Falck Christian, Kruschewski Martin, Wacker Frank, Meyer Bernhard Christian

机构信息

Klinik für Radiologie, Charité Universitätsmedizin Berlin, Berlin, Germany.

Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.

出版信息

PLoS One. 2015 Apr 2;10(3):e0119900. doi: 10.1371/journal.pone.0119900. eCollection 2015.

OBJECTIVES

To investigate the reliability of CT-angiography of the lower extremities (run-off CTA) to derive a treatment decision in patients with acute and chronic peripheral artery disease (PAD).

MATERIALS AND METHODS

314 patients referred for run-off CTA were includ-ed in this retrospective study. First, diagnostic confidence of run-off CTA to derive a treat-ment decision was assessed in an interdisciplinary vascular conference using a 2 point scale (sufficient or not sufficient diagnostic confidence) and compared with the image quality eval-uated by two readers in consensus in four different levels (abdominopelvic, thigh, calf, foot arteries). Second, reliability of treatment decision was verified in all patients undergoing re-vascularization therapy.

RESULTS

Diagnostic confidence of run-off CTA to derive a treatment deci-sion was sufficient in all patients with acute and in 97% of patients (215/221) with chronic PAD, whereas the rate of run-off CTA with non-diagnostic image quality was considerably higher in the calf and foot level (acute vs. chronic; calf: 28% vs.17%; foot: 52% vs. 20%). Reliability of treatment decision was superior for patients with chronic (123/133 = 92%) than for patients with acute PAD (64/78 = 82%, P = 0.02).

CONCLUSION

Run-off CTA is a reliable imaging modality for primary diag-nostic work-up of patients with acute and chronic PAD.

目的

探讨下肢CT血管造影（CTA全程扫描）在急性和慢性外周动脉疾病（PAD）患者中用于制定治疗决策的可靠性。

材料与方法

本回顾性研究纳入了314例行CTA全程扫描的患者。首先，在跨学科血管会议上采用两点量表（诊断信心充足或不足）评估CTA全程扫描用于制定治疗决策的诊断信心，并与两位阅片者一致评估的四个不同水平（腹盆腔、大腿、小腿、足部动脉）的图像质量进行比较。其次，在所有接受血管重建治疗的患者中验证治疗决策的可靠性。

结果

CTA全程扫描用于制定治疗决策的诊断信心在所有急性PAD患者以及97%（215/221）的慢性PAD患者中充足，而在小腿和足部水平图像质量无法诊断的CTA全程扫描比例明显更高（急性与慢性相比；小腿：28%对17%；足部：52%对20%）。慢性PAD患者治疗决策的可靠性（123/133 = 92%）优于急性PAD患者（64/78 = 82%，P = 0.02）。