The Clinical Apply Of MSCT Angioreaphy In Diagnosis Of Vessel

Objective To discuss the clinical value of 16-slice CT angiography in diagnosis of vessel disease and to investigate the effect of atherosclerotic plaque composition on the extent of stenosis.To compare the various image reformations in order to observed mainly atherosclerotic plaques.Methods 119 cases clinically suspected with arteriosclerotic disease were performed with MSCTA.The data was transmitted to ADW4.3workstation,and reconstructed.CTA images included original transverse images and VR,MIP,CPR,VE and AVA generally analyzed with arteriosclerotic diaease.Then diagnosed plaque and classified calcify plaque,middle plaque and flexible plaque.The images of 93 plaques in 28 patients were studied double-blindly by two experienced radiologists.Diameters,cross-sectional areas of the most stenotic and distal nonstenotic vessels were calculated.Results The three-dimensional reconstruction of MSCTA could clearly display the vascular anatomy,pathological conditions.248 plaques were detected on CTA.82 were non-calcified,74 were calcified and 90 mixedplaque.194 plaque causedⅠstenosis,32 plaque causedⅡstenosis,22 plaque caused significant atenosis,and 37 occlusive on CTA in 248 plaques and 37 occlusive.There are statistically difference in stenosis between linear,area and AVA.About area stenosis rate,AVA were significantaly greater than the linear stenosis rate.The grade on area and AVA were higher than that on other methods in most vessels.CTA could also reveal soft plaque,fibrous plaque and calcific plaque,CT value in each plaque type could be estimate.The CT value of soft plaque,fibrous plaque,and calcific plaque was less than 50Hu,50～150Hu,and more than 300Hu. There was significant difference between VR,MIP,MPR and VE in a plaque. Various image reformations have different advantages.Conclusion MSCTA is a noninvasive and effective angiographic method,it can not only detect,but also distinguished in diagnosis of vascular diseases.Area stenosis rate,AVA were is more accurate than the linear stenosis rate in evaluating atherosclerotic lesions.Various image reformations have different advantages in quantitative analysis in aortoiliac artery stenosis.AVA is the first choice which is a multifunctional,convenient and repeatable.It can offer more valuable information for the diagnosis and treatment of atherosclerotic lesions and assessment for the therapeutic efficacy.CTA can accurately and objectively diagnose arter stenosis,and evaluate the plaque,was accurate for detecting noncalcified plaque and stenosis.Plaque irregularities demonstrated most frequent on MIP and MPR images in others.55 plaque were observed on VE,and 43 plaque were abserved by VR.MSCT combining the four reconstruction techniques was valuable to demonstrate whether there is arterosclerotic plaque and stenosis and degree or length of artery lesion.The information can be helpful for the patients managerment.It become the first modality to diagnose and evaluate the curative effect.