PURPOSE:A prospective evaluation of spiral CT angiography (SCTA) as the sole pre-operative imaging modality for abdominal aortic aneurysm repair.

MATERIALS AND METHODS:Spiral CT angiography was compared with conventional transfemoral angiography in 30 patients and results correlated with surgical findings in 22 patients. The following features were assessed: renal artery number and disease; upper and lower aneurysm extent; aneurysm size; perianeurysmal inflammation; iliac artery disease; radiation dose; and contrast usage.

RESULTS:Spiral CT angiography agreed with conventional angiography in all cases of severe stenosis or occlusion of renal arteries and had 90% agreement overall for renal artery disease. Two of nine accessory renal arteries seen at conventional angiography were missed. For showing aneurysm extent SCTA was 100% sensitive, and performed better than conventional angiography. Aneurysm size was better shown with SCTA. In iliac disease SCTA, as performed in this study, was poor for mild-moderate disease, but detected four of six severely stenosed/occluded iliac arteries seen at conventional angiography. Prospective sensitivity for perianeurysmal inflammation was 33%. Radiation dose for SCTA was approximately twice and contrast dose approximately three times that for conventional angiography.

CONCLUSION:Spiral CT angiography can provide all the necessary imaging information to plan aneurysm repair in the non-claudicant.

译文

目的 : 对螺旋ct血管造影 (SCTA) 作为腹主动脉瘤修复的唯一术前成像方式的前瞻性评估。
材料和方法 : 将30例患者的螺旋ct血管造影与常规经股动脉造影进行了比较,结果与22例患者的手术结果相关。评估了以下特征: 肾动脉数量和疾病; 上,下动脉瘤范围; 动脉瘤大小; 动脉瘤周围炎症; 髂动脉疾病; 辐射剂量; 和造影剂使用。
结果 : 在所有严重肾动脉狭窄或闭塞的病例中,螺旋ct血管造影与常规血管造影一致,并且在肾动脉疾病方面总体上90% 一致。在常规血管造影中观察到的9条副肾动脉中有2条被遗漏。对于显示动脉瘤范围,SCTA 100% 敏感,并且比常规血管造影更好。SCTA能更好地显示动脉瘤大小。在本研究中进行的SCTA在轻度-中度疾病中较差,但在常规血管造影术中发现了六个严重狭窄/闭塞的动脉中的四个。33% 了对动脉瘤周围炎症的前瞻性敏感性。SCTA的辐射剂量约为常规血管造影的两倍,造影剂剂量约为常规血管造影的三倍。
结论 : 螺旋ct血管造影可以提供所有必要的成像信息,以计划非幽闭者的动脉瘤修复。

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