Raptopoulos V, Rosen M P, Kent K C, Kuestner L M, Sheiman R G, Pearlman J D
Department of Radiology, Beth Israel Hospital, Boston, MA 02215, USA.
AJR Am J Roentgenol. 1996 Jun;166(6):1347-54. doi: 10.2214/ajr.166.6.8633446.
The purpose of this work was to study aortoiliac disease with sequential helical CT angiography.
Sequential helical CT angiography combines two successive helical sets for data acquisition obtained during two successive bolus injections of IV contrast material and two breath-holds. Twenty-eight patients with aneurysm and 11 with occlusive disease had CT angiography. Of those 39 patients, 18 also had conventional catheter angiography. For each of the 39 patients, a CT angiogram of three segments of the aorta and 13 arteries was assessed, including the suprarenal, juxtarenal, and infrarenal aorta; celiac axis; superior and inferior mesenteric arteries; and pairs of renal, common iliac, hypogastric, external iliac, and common femoral arteries. In 18 patients undergoing both CT and conventional angiography, the appearance of these vessels was graded as occlusive (grade 0), severely stenotic (grade 1), moderately stenotic (grade 2), mildly stenotic (grade 3), normal (grade 4), ectatic (grade 5), and aneurysmal (grade 6).
Of the 624 arteries expected to be opacified in 39 patients, 585 (94%) were actually imaged with CT angiography. In the 18 patients who had both CT angiography and catheter angiography, the two studies were in complete agreement in 243 (90%) of 269 arteries. In 13 vessels (5%), CT angiography produced an image that was one grade higher-and in 11 vessels (4%), one grade lower-than conventional angiography. In two vessels, a two-grade difference was noted. The independent readings matched on the 0-6 scale in 95% of the evaluations. An additional 5% of the readings differed by one unit. Compared with conventional angiography, CT angiography of clinically significant (> or = 85%) narrowing (grades 0 and 1) and aneurysm (grade 6) yielded sensitivity of 93%, specificity of 96%, and accuracy of 95%.
Sequential helical CT angiography of the abdomen can provide sufficient vascular detail to allow evaluation of expanded vascular territories. The technique can allow accurate assessment of both stenotic and aneurysmal disease of the aorta and the iliac arteries.
本研究旨在通过连续螺旋CT血管造影术研究主髂动脉疾病。
连续螺旋CT血管造影术结合了两组连续的螺旋扫描，用于在两次连续静脉注射造影剂和两次屏气过程中获取数据。28例动脉瘤患者和11例闭塞性疾病患者接受了CT血管造影检查。在这39例患者中，18例还接受了传统导管血管造影检查。对39例患者中的每一例，均评估了主动脉三段及13条动脉的CT血管造影图像，包括肾上腺上、肾上腺旁及肾上腺下主动脉；腹腔干；肠系膜上、下动脉；以及双侧肾动脉、髂总动脉、腹下动脉、髂外动脉和股总动脉。在18例同时接受CT和传统血管造影检查的患者中，这些血管的表现被分为闭塞（0级）、重度狭窄（1级）、中度狭窄（2级）、轻度狭窄（3级）、正常（4级）、扩张（5级）和动脉瘤（6级）。
在39例患者预期显影的624条动脉中，585条（94%）实际通过CT血管造影成像。在18例同时接受CT血管造影和导管血管造影的患者中，两项检查在269条动脉中的243条（90%）上完全一致。在13条血管（5%）中，CT血管造影产生的图像比传统血管造影高一级，在11条血管（4%）中低一级。在两条血管中，发现有两级差异。在95%的评估中，独立读数在0 - 6级上匹配。另外5%的读数相差一个单位。与传统血管造影相比，CT血管造影对临床上有意义的（≥85%）狭窄（0级和1级）和动脉瘤（6级）的敏感性为93%，特异性为96%，准确性为95%。
腹部连续螺旋CT血管造影可提供足够的血管细节，以便对扩大的血管区域进行评估。该技术能够准确评估主动脉和髂动脉的狭窄及动脉瘤性疾病。
