【摘要】 目的 比较计算机断层扫描血管成像(CTA)中容积再现(VR)、多平面重建(MPR)、最大密度投影(MIP)、曲面重建(CPR)4种后处理技术在评估主髂动脉狭窄程度中的效果。方法 回顾性分析我院收治的疑似主髂动脉狭窄患者的临床数据共计100例，选例时间为2024年6月至2025年12月。所有患者均行CTA检查及数字减影血管造影(DSA)检查。分析DSA检查主髂动脉节段狭窄程度分布情况；参照泛大西洋协作组织(TASC)II分型标准对主髂动脉病变进行分型；以DSA为金标准，分析VR、MPR、MIP、CPR的评估结果及诊断效能；比较不同狭窄程度的评估符合率。结果 100例患者共纳入186段主髂动脉，经DSA检查确诊：正常32段(17.20%)、轻度狭窄48段(25.81%)、中度狭窄56段(30.11%)、重度狭窄38段(20.43%)、闭塞12段(6.45%)。根据DSA评估的病变特征，参照TASCⅡ分型标准对100例患者的主髂动脉病变进行分型：A型22例(22.00%)、B型20例(20.00%)、C型41例(41.00%),D型17例(17.00%)，其中以C型复杂病变最为常见，其次为A型和B型。在纳入分析的186段主髂动脉节段中，DSA确诊有临床意义狭窄106段，无临床意义狭窄80段。在四种CTA后处理技术中，MPR技术对狭窄的检出与DSA一致性最高。MPR技术在敏感度(97.17%)、特异度(96.25%)、准确度(96.77%)、阳性预测值(97.17%)及阴性预测值(96.25%)方面均优于其他三种后处理技术。MPR技术轻度、中度、重度、闭塞中的评估符合率均为最高，但四种后处理技术之间的评估符合率差异均无统计学意义(P>0.05)。结论 MPR技术在主髂动脉狭窄程度评估中的准确性、一致性均优于VR、MIP、CPR技术，能更精准地反映主髂动脉狭窄情况，且基于DSA的TASCⅡ分型凸显了病例的复杂性。更多还原

【Abstract】 Objective To compare the effects of four post-processing techniques,namely volume rendering(VR),multi-planar reconstruction(MPR),maximum intensity projection(MIP),and curved plannar reconstruction(CPR),in evaluating the degree of stenosis of the main iliac arteries in computed tomography angiography(CTA).Methods This study employed a retrospective analysis method to exa mine the clinical data of 100 patients with suspected main iliac a rtery stenosis who were admitted to our hospital.The selection period was from June 2024 to December 2025.All patients underwent CTA examination and digital subtraction angiogra phy(DSA) exa mination.Analyze the distribution of the degree of segmental stenosis in the main iliac arteries through DSA exa mination;classify the main iliac artery lesions according to the TASC Ⅱ classification standard;use DSA as the gold standard to analyze the evaluation results and diagnostic efficacy of VR,MPR,MIP,and CPR;compare the assessment compliance rates of the four CTA post-processing techniques for different degrees of stenosis.Results A total of 100 patients were included in 186 segments of the main iliac arteries.Through DSA exa mination,the diagnosis was confirmed:32 segments(17.20%) were normal,48 segments(25.81%)had mild stenosis,56 segments(30.11%) had moderate stenosis,38 segments(20.43%) had severe stenosis,and 12 segments(6.45%) we re occluded.Based on the lesion chara cteristics evaluated by DSA,the main iliac artery lesions of 100 patients were classified acco rding to the TASC Ⅱ classification criteria:22 cases(22.00%) were type A,20 cases(20.00%) were type B,41 cases(41.00%) were type C,and 17cases(17.00%) were type D.Among them,the most common type was type C,followed by type A and type B.Among the 186 segments of the main iliac arteries included in the analysis,106 segments were confirmed by DSA to have clinically significant stenosis,and 80 segments had no clinically significant stenosis.Among the four post-processing techniques of CTA,the MPR technique had the highest consistency in detecting stenosis compared to DSA.The MPR technique outperformed the other three post-processing techniques in terms of sensitivity(97.17%),specificity(96.25%),accuracy(96.77%),positive predictive value(97.17%),and negative predictive value(96.25%).The assessment accuracy rates of MPR technology for mild,moderate,severe and occluded conditions were all the highest.However,there was no statistically significant difference in the assessment accuracy rates among the four post-processing techniques(P>0.05).Conclusion The accuracy and consistency of MPR technology in evaluating the degree of iliac a rtery stenosis a re superior to those of VR,MIP,and CPR technologies.It can more accu rately reflect the condition of iliac a rtery stenosis and highlights the complexity of the case based on the TASC Ⅱ classification based on DSA.更多还原