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:前瞻性评价螺旋CT血管造影(SCTA)作为腹主动脉瘤修复术前唯一的影像学检查方法。

材料与方法:螺旋CT血管造影与常规经股动脉血管造影在30例患者中进行了比较,结果与22例患者的手术结果相关。评估以下特征:肾动脉数量和疾病;上下动脉瘤程度;动脉瘤大小;动脉瘤周围炎;动脉疾病;辐射剂量

结果:在所有严重狭窄或阻塞性肾动脉的病例中,螺旋CT血管造影与常规血管造影相符,并且总体上90%同意用于肾动脉疾病。在常规血管造影术中发现的9条辅助肾动脉中有2条漏诊了。为了显示动脉瘤的程度,SCTA是100%敏感的,并且比常规的血管造影术表现更好。使用SCTA可以更好地显示动脉瘤的大小。在这项研究中进行的动脉疾病中,SCTA对于轻度中度疾病较差,但在常规血管造影术中发现了6条严重狭窄/闭塞的动脉中的4条。对动脉瘤周围炎症的预期敏感性为33%。 SCTA的放射剂量约为常规血管造影的两倍,对比剂量约为传统血管造影的三倍。

结论:螺旋CT血管造影可以提供所有必要的影像学信息,以计划在非-claudicant。

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