肾动脉狭窄的螺旋CT：三维重建技术的比较

Spiral CT of renal artery stenosis: comparison of three-dimensional rendering techniques.

作者信息

Rubin G D, Dake M D, Napel S, Jeffrey R B, McDonnell C H, Sommer F G, Wexler L, Williams D M

机构信息

Department of Radiology, Stanford University Hospital and Medical Center, CA 94305-5105.

出版信息

Radiology. 1994 Jan;190(1):181-9. doi: 10.1148/radiology.190.1.8259402.

DOI:10.1148/radiology.190.1.8259402

PMID:8259402

Abstract

PURPOSE

To evaluate the accuracy of computed tomographic (CT) angiography in the detection of renal artery stenosis (RAS).

MATERIALS AND METHODS

CT angiography was performed in 31 patients undergoing conventional renal arteriography. CT angiographic data were reconstructed with shaded surface display (SSD) and maximum-intensity projection (MIP). Stenosis was graded with a four-point scale (grades 0-3). The presence of mural calcification, poststenotic dilatation, and nephrographic abnormalities was also noted.

RESULTS

CT angiography depicted all main (n = 62) and accessory (n = 11) renal arteries that were seen at conventional arteriography. MIP CT angiography was 92% sensitive and 83% specific for the detection of grade 2-3 stenoses (> or = 70% stenosis). SSD CT angiography was 59% sensitive and 82% specific for the detection of grade 2-3 stenoses. The accuracy of stenosis grading was 80% with MIP and 55% with SSD CT angiography. Poststenotic dilatation and the presence of an abnormal nephrogram were 85% and 98% specific, respectively.

CONCLUSION

CT angiography shows promise in the diagnosis of RAS. The accuracy of CT angiography varies with the three-dimensional rendering technique employed.

摘要

目的

评估计算机断层扫描（CT）血管造影在检测肾动脉狭窄（RAS）方面的准确性。

材料与方法

对31例行传统肾动脉造影的患者进行CT血管造影。CT血管造影数据采用表面阴影显示（SSD）和最大密度投影（MIP）进行重建。狭窄程度采用四点量表（0 - 3级）进行分级。同时记录壁钙化、狭窄后扩张和肾造影异常情况。

结果

CT血管造影显示了传统动脉造影中所见的所有主要肾动脉（n = 62）和副肾动脉（n = 11）。MIP CT血管造影检测2 - 3级狭窄（≥70%狭窄）的敏感度为92%，特异度为83%。SSD CT血管造影检测2 - 3级狭窄的敏感度为59%，特异度为82%。MIP CT血管造影狭窄分级的准确率为80%，SSD CT血管造影为55%。狭窄后扩张和异常肾图的特异度分别为85%和98%。