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目的 探讨螺旋CT血管造影 (SCTA)对诊断肾动脉狭窄的临床应用价值。方法 对 2 5例临床疑为肾动脉狭窄的患者行SCTA ,其中 12例经X线血管造影 (XRA) (包括DSA)对照。层厚 2～ 3mm ,重建间隔 1.0mm ,螺距 1.0～ 1.2 5 ,管电流 12 0～ 15 0mA ,管电压均为 12 0kV。造影剂使用欧乃派克 3 0 0mgI ml 75～ 10 0ml ,采用高压注射器方式经肘静脉给药 ,注射流速 3ml s ,延迟 2 2～ 2 7s扫描 ,扫描结束后行MPR和 3D重建。结果 2 5例中SCTA显示肾动脉正常 3 9条 ,肾动脉狭窄 13条 ,共 5 2条。 12例有XRA对照者 ,显示肾动脉正常 11条 ,肾动脉狭窄 13条 ,SCTA显示的情况与之完全符合。结论 SCTA合理的成像技术和综合的图像分析 ,能清楚显示肾动脉并对肾动脉的狭窄部位和程度作出可靠诊断 ,具有重要的临床价值。
Objective To investigate the clinical value of spiral CT angiography (SCTA) in the diagnosis of renal artery stenosis. Methods Twenty-five patients with clinically suspected renal artery stenosis underwent SCTA. Twelve of them underwent X-ray angiography (DSA), including DSA. Layer thickness 2 ~ 3mm, reconstruction interval 1.0mm, pitch 1.0 ~ 1.2 5, the tube current 12 0 ~ 15 0mA, the tube voltage is 12 0kV. The contrast agent used Omnipak 3000mg ml to 10ml. The patients were administrated with high pressure syringe through the elbow vein. The flow rate of injection was 3ml s and the delay was 2 2 ~ 27s. After the end of the scan, MPR and 3D reconstruction were performed. Results 25 cases of SCTA showed normal renal artery 39, renal artery stenosis 13, a total of 52. Twelve patients with XRA showed normal 11 renal arteries and 13 renal artery stenoses. The SCTA showed exactly the same. Conclusion SCTA reasonable imaging techniques and comprehensive image analysis, can clearly show the renal artery and renal artery stenosis site and degree to make a reliable diagnosis, has important clinical value.