Rieker O, Düber C, Neufang A, Pitton M, Schweden F, Thelen M
Department of Radiology, Klinik für Radiologie, Johannes Gutenberg-Universität Mainz, Germany.
AJR Am J Roentgenol. 1997 Oct;169(4):1133-8. doi: 10.2214/ajr.169.4.9308477.
The purpose of this study was to evaluate the accuracy of CT angiography (CTA) with a single helical acquisition for assessment of stenoses and occlusions of the iliac arteries.
In our prospective study, intraarterial digital subtraction angiography and IV CTA were performed from the suprarenal aorta to below the femoral bifurcation in 30 patients with vascular occlusive disease. Maximum-intensity-projection images in multiple views were also obtained. The accuracy of CTA with and without analysis of axial images was determined.
Sensitivity and specificity of CTA were 100% for iliac artery occlusions with a confidence interval 85-100% and 97-100%, respectively. When axial scans were interpreted, 14 of 15 high-grade (> 75%) stenoses were recognized. Sensitivity and specificity of CTA were 93% (range, 68-100%) and 99% (range, 97-100%), respectively. When maximum intensity projections alone were analyzed, sensitivity for the diagnosis of 15 high-grade stenoses was only 53% (range, 27-79%) because calcified plaques obscured six stenoses.
CTA accurately reveals iliac artery occlusions. Observers of CT angiograms may overlook short stenoses in rare instances. Calcified plaques limit the use of maximum-intensity-projection images.
本研究旨在评估单螺旋采集的CT血管造影（CTA）用于评估髂动脉狭窄和闭塞的准确性。
在我们的前瞻性研究中，对30例血管闭塞性疾病患者从肾上腺主动脉至股动脉分叉下方进行了动脉内数字减影血管造影和静脉CTA检查。还获取了多个视角的最大密度投影图像。确定了有无轴位图像分析的CTA准确性。
CTA对髂动脉闭塞的敏感性和特异性分别为100%，置信区间分别为85% - 100%和97% - 100%。当解读轴位扫描时，15处重度（>75%）狭窄中有14处被识别。CTA的敏感性和特异性分别为93%（范围68% - 100%）和99%（范围97% - 100%）。当仅分析最大密度投影时，15处重度狭窄的诊断敏感性仅为53%（范围27% - 79%），因为钙化斑块掩盖了6处狭窄。
CTA能准确显示髂动脉闭塞。CT血管造影的观察者在罕见情况下可能会忽略短段狭窄。钙化斑块限制了最大密度投影图像的应用。
