The Comparative Investigation Of Mutilslices Spiral Ct Angiography With Dsa In Lower Extremity Arteriosclerosis Obliterans

Objective:To investigate the practical value of multislice spiral CT angiography (MSCTA) and the reconstructions in lower extremity arteriosclerosis obliterans (LEASO).Methods:The images and clinical data of 40 patients with LEASO were reviewed and all the images were reconstructed by MPR, MIP, VR. All the results were analized with kappa test. To evaluate the diagnostic effectiveness in LEASO with MSCTA and the reconstructions (sensitivity, specificity, accurateness, positive and negative predictive value were include). Chi-square test was used in CTA and several reconstructions for LEASO coincidence rate.Results:(1) There was diagnostic value in MSCTA and reconstructions (CTA-MPR, CTA-MIP and CTA-VR) to diagnose LEASO (K value>0.75). (2) The sensitivity rate were 97.8%,99.1%,98.2% and 98.2% respectively to diagnose LEASO(the stenosis rate of 50%) with MSCTA and the reconstructions (CTA-MPR,CTA-MIP and CTA-VR). the specificity rate were 98.4%,95.4%,98.4% and 98.4%, the accurateness rate were 98.1%,97.4%,98.4%,98.4%, the positive predictive rate were 98.6%,96.1%,98.3%,98.3% and the negative predictive rate were 97.5%,98.9%,98.2%,98.2%. The sensitivity rate were 100%,100%,100% and 100% respectively to diagnose LEASO (the blood vessel was blocked totally) with MSCTA and the reconstructions (CTA-MPR,CTA-MIP and CTA-VR), the specificity rate were 98.6%,98.6%,96.5%,96.5%, the accurateness rate were 98.8%,98.8%, 96.9%,96.9%, the positive predictive rate were 90.9%,90.9%,79.3%,79.3% and the negative predictive rate were 100%,100%,100% and 100%. (3) There was no statistic difference between CTA-MPR and CTA to diagnose LEASO (P value>0.05).There was statistic difference among CTA-MIP, CAT-VR and CTA to diagnose LEASO (P value<0.05).Conclusion:(1) MSCTA is a valuable method in diagnosing LEASO and can partly replace DSA. (2). The reconstructions (MPR, MIP, VR) can be judged the blockage of the blood vessels more intuitively in LEASO, and cross sectional images can be measured more accurately for the stenosis rate. The both benefits should be combined to improve the diagnosis and image quality. (3) As a non-invasive, high accurate, fast-acquisition, high space resolution, low-complication technique of vascular imaging, MSCAT can become a primary bolting method in diagnosing lower extremity arteriosclerosis obliterans.