85例老年患者下肢动脉血管成像技术检查结果分析

目的 评价16层螺旋CT下肢动脉成像在诊断老年患者下肢动脉硬化闭塞症合并其它不同基础疾病中的临床价值.方法 对85例临床疑似下肢动脉硬化的老年患者行16层螺旋CT下肢动脉血管成像（CT angiography,CTA）扫描,以容积再现（volume rendering,VR）,最大密度投影（maximum intensity projection,MIP）以及曲面重建（curved reformate,CR）技术重建.按糖尿病、高血压病因分组,比较下肢动脉CTA检查结果.结果 CTA检查可以清晰显示双下肢动脉及主要分支病变的部位、范围及侧枝循环.49例血管不同程度钙化患者中,高血压组、糖尿病合并高血压组较糖尿病组下肢动脉管壁钙化的病例出现更多（P＜0.05）.43例不同程度的下肢动脉狭窄及闭塞患者中,糖尿病合并高血压组较高血压组、糖尿病组的闭塞病例出现更多（P＜0.05）.结论 糖尿病合并高血压组患者的下肢动脉硬化闭塞症表现较糖尿病组及高血压组患者更为严重.对存在易患因素的老年人群,尤其是同时具有高血压和糖尿病病因者,下肢动脉CTA检查具有筛选价值.

Analysis on results of CT angiography of lower extremities in 85 geratic patients

Objective To evaluate the 16-slice spiral CT imaging in the diagnosis of lower extremity arteriosclerosis obliterans （ASO） in geratic patients coexisted with various basic pathological changes. Methods CT angiography （CTA） was performed in 85 geratic patients suspected lower extremity arterial occlusive diseases with 16-slice spiral CT set. Images were reconstructed by volume rendering （VR）, maximum intensity projection （MIP） and Curved Reformate （CR）. By hypertension, diabetes etiology grouping, comparing lower extremity arterial CTA findings. Results CTA display not only the location, extent of the lesions, but also the collateral vessels of lower extremity arterial. Among the 49 cases with cal- cification of vessel wall, the calcification was revealed much more severe in the group of hypertension, diabetes combined with hypertension, than that of the sole diabetetes （P〈0.05）. Among the 43 cases with various degree of lower extremity arterial stenosis and occlusion, the totally occluded cases were much more revealed in the group of diabetes combined with hypertension than that of the sole hypertension or diabetes （P〈0.05）. Conclusion The occlusion in the group of diabetes combined with hypertension was much more severe than that of the sole diabetes and hypertension. To detect the lower ex- tremity arterial by CTA is of significant value in screening the ASO in geratic patients with risk factors, especially for that with coexisted hypertension and diabetes.