CHEN Yonghua,FU Gangze,CHEN Cong, et al. The clinical value of low tube voltage CTA in the diagnosis of acute lower extremity trauma with vascular injury[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2018, 48(9): 667-671.
Abstract：Objective: To explore the feasibility of 100 kV low tube voltage CTA (L-CTA) in the diagnosis of acute lower limb trauma with vascular injury. Methods: Thirty patients of suspected lower limb trauma with acute vascular injury were examined by L-CTA. Objective parameter, subjective scoring of image quality and radiation dose were analyzed. Compared with the results of emergency surgery, the sensitivity and accuracy of L-CTA in the diagnosis of vascular injury were evaluated. Results: The subjective image quality was good and the scores were all above 3 in the L-CTA group. Compared with conventional CTA of lower extremity, the L-CTA group had an increase in vessel density (VD) and noise (P<0.05). There was no significant difference in signal noise ratio (SNR) and contrast noise ratio (CNR) between two groups (P>0.05). Volume CT dose index (CTDIvol) and dose length product (DLP) in the L-CTA group were lower than those in the conventional group (P<0.05), with the radiation dose decreased by 32%. L-CTA was used to diagnose 18 cases of arterial occlusion, including 2 cases of arterial wall rupture, 5 cases of arterial stenosis, 4 cases of pseudoaneurysm, and 3 cases of arteriovenous fistula. The sensitivity of diagnosis was 100% and the diagnostic coincidence rate was 90%, comparing with the results of emergency surgery. Conclusion: 100 kV L-CTA examination for patients with acute lower limb trauma combined with vascular injury could meet the diagnostic needs and effectively reduce the radiation dose.
