Wartość 64-rzędowej angiografii tomografii komputerowej jako ostrodyżurowej metody diagnostycznej w ostrym niedokrwieniu kończyn dolnych

Bibliogr. s. 41

Background: "Acute limb ischemia" (ALI) is a quickly progressing or a sudden impairment of limb perfusion. It manifests itself by acute symptoms or intensification of already existing symptoms, and may often pose a threat to limb viability. Computed tomography angiography (CTA) performed with multidetector CT (MDCT) can precisely visualize ALI within limb arteries. Its main advantages are: short time of examination, minimal invasiveness and possibility of multiplanar and volumetric visualisation in the vessels and adjacent tissues. The aim of our work was to present our own method and to analyse the results of CTA examination performed with 64-row detector CT in patients with symptoms of acute limb ischemia Material/Methods: Material included 43 patients (29 men, 14 women - mean age 62 years) diagnosed during the emergency service of Department of General Radiology, Interventional Radiology and Neuroradiology, Wrocław Medical University, due to suspicion of the acute lower limb ischemia evolved in thromboembolic mechanism. CTA examinations were performed with a LightSpeed 64 scanner (GE Healthcare). The obtained images were analysed with the use of a AW4.4 workstation. Results: The pathological changes concern first of all the arteries of iliac axis, followed by the arteries of femoral axis. Acute occlusions of lower leg arteries were always associated with occlusions within other arteries. Forty-two cases of occlusion, diagnosed with CTA, were confirmed by angiographic examination or in the course of surgery (sensitivity: 98%). The occlusion of the whole vessel was shown in 87% of all occlusions, while the segmental occlusion in 13% only. Conclusions: CTA examination performed with the 64-row multidetector CT unit showed a substantial effectiveness in pathology detection within the lower limb arteries in patients with symptoms of acute limb ischemia. Therefore CTA should be considered a basic diagnostic method of acute limb ischaemia, during emergency service.