摘要
目的：探讨双源螺旋CT血管成像术在糖尿病足合并严重下肢动脉疾病中的应用价值。方法：对30例糖尿病足临床表现有下肢缺血症状患者行双源螺旋CT血管成像，扫描范围从腹主动脉水平达足底。同时一周内行X线数字减影血管造影（digital subtraetion angiography，DSA）检查，对比评价双源螺旋CT血管成像术（erA）的应用价值。将观测动脉分为两组：A组：股动脉、股浅动脉、胭动脉；B组：胫腓干动脉、胫前动脉、胫后动脉、腓动脉、足背动脉。结果：在A组，CTA对病变的诊断与DSA的一致性K值为0．787，而B组膝下动脉的一致性K值为0．649，较A组略低。在A组：CTA共发现68处病变，其中54（79．4％）个狭窄闭塞的程度与DSA一致，8个节段（12％）狭窄程度被低估1个级别，6个节段（9％）被高估了1个级别，1个节段（1．5％）被高估了2个级别。狭窄程度被高估2个级别的节段均伴有严重的管壁钙化。对管腔达中度狭窄以上（含中度狭窄）的动脉，CTA诊断的敏感度、准确性和特异性分别为93．3％（95％CI，91．4％～95．1％）、94．8％（95％CI，92．1％～97．7％）、95．5％（95％CI，93．2％～97．4％）。在B组，CTA共发现141处病变，其中101（71．6％）个狭窄闭塞的程度与DSA一致，17个节段（12％）狭窄程度被低估1个级别，3个节段（2％）被低估2个级别，1个节段（0．5％）被低估3个级别；19个节段（13．5％）被高估了1个级别，2个节段（1．5％）被高估了2个级别。对管腔达中度狭窄以上（含中度狭窄）的动脉，CTA诊断的敏感度为91．9％（95％CI，88．2％～96．1％）、90．6％（95％CI，88．4％～93．1％）、91．7％（95％CI，88．3％～95．8％）。结论：作为一种无创、简便和相对便宜的检查方法，erA能给临床医生提供相对准确和全面的糖尿病足下肢动脉病变的评估，对血管重建手术的术前准备和术后随访都有重要的临床价值。
Objective：To assess the role of slice spiral CT angiography for lower limb arterial diseases in diabetic foot. Methods：30 cases of diabetic feet with lower limb arteries were studied , the helical scans covered abdominal aorta to the artery of the lower extremity. We used Siemens Wizard workstation for 3D reconstruction. All the cases underwentdigital subtraction angiography （DSA） in a week. All the observed arteries were divided into two groups i.e., group A included common femoral artery, the superficial femoral artery and the popliteal artery, whiles group B included the anterior tibial artery, the posterior tibial artery, the peroneal artery and the dorsal pedal artery. Results：The kappa value was 0.787 in group A and, 0.649 in group B. With regard to segments that had more than moderate stenosis, the scnsitivity, specificity and accuracy of MIP were 93.3%, 94.8%, 95.5% in group A, whiles in group B the sensitivity, specificity and accuracy of MIP were 91.9%, 90.6%, 91.7%. Conclusion：The assessment of angiography of diseases of lower limb arteries with slice spiral CT is equal to DSA in diebefic foot patients, which can be used in the evaluation before and behind the reconstitution of the lower limb arteries.
出处
《医学影像学杂志》
2008年第9期1025-1028,共4页
Journal of Medical Imaging
