摘要
目的探讨256层CT血管造影(CTA)在下肢动脉硬化闭塞性病变(ASO)诊断中的应用价值。方法选取2016年3月至2018年3月大连医科大学附属第二医院收治的54例疑似ASO患者作为研究对象。所有患者均行下肢256层CTA检查,并进行血管三维重建。于1～2周内行数字减影血管造影(DSA)检查。分析比较两种检查方法诊断评估血管狭窄分级的符合率,以DSA检查结果为"金标准",计算256层CTA检查诊断ASO的敏感度、特异度、阳性预测值、阴性预测值以及准确率等诊断效能。结果 54例患者共进行检测了776段血管,其中256层CTA检查与DSA检查诊断血管狭窄分级结果相同的有740段血管,诊断符合率为95.36%(740/776)。以动脉狭窄程度超过50%为ASO的诊断标准,256层CTA检查诊断ASO的敏感度、特异度、阳性预测值、阴性预测值和准确率分别为99.45%(360/362)、98.07%(406/414)、97.83%(360/368)、99.51%(406/408)、98.71%(766/776)。结论 256层CTA检查进行诊断下肢动脉硬化闭塞性病变,能全面显示下肢动脉病变细节,诊断的准确性良好,且操作无创、方便,对于ASO的诊断具有较高的应用价值。
Objective To evaluate the diagnostic value of 256-slice CT angiography in arteriosclerotic occlusive lesions(arteriosclerotic occlusivedisease, ASO) of lower extremities. Methods From March 2016 to March 2018, 54 patients with suspected ASO treated in the second affiliated Hospital of Dalian Medical University were selected as the subjects of study. All patients were received with 256-slice CT angiography and three-dimensional vascular reconstruction. Then digital subtraction angiography(DSA) was performed within 1 to 2 weeks. The coincidence rate of the two methods in the diagnosis and evaluation of vascular stenosis classification were analyzed and compared. The results of DSA were regarded as gold standard, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 256-layer CT angiography for ASO diagnosis were calculated. Results A total of 776 segments of blood vessels were detected in 54 patients, of which 740 were diagnosed by CT angiography and DSA, and the diagnostic coincidence rate was 95.36%(740/776). The degree of stenosis was more than 50% as the diagnostic criterion of ASO, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CT angiography in the diagnosis of ASO were 99.45%(360/362), 98.07%(406/414), 97.83%(360/368), 99.51%(406/408),98.71%(766/776), respectively. Conclusion 256-slice CT angiography for diagnosis of arteriosclerotic occlusive lesions of the lower extremities can fully display the details of arterial lesions of the lower extremities, the accuracy of diagnosis is good, and the operation is non-invasive and convenient, which has a high guiding value for the diagnosis and treatment of ASO.
作者
孙伟航
张骜丹
李巍
Sun Weihang;Zhang Aodan;Li Wei(Department of Radiology, the Second Affiliated Hospital of Dalian Medical University, Dalian 116023, Liaoning, China;Department of Hepatobiliary, Pancreatic Surgery,the Second Affiliated Hospital of Dalian Medical University, Dalian 116023, Liaoning, China)
出处
《血管与腔内血管外科杂志》
2018年第5期403-407,共5页
Journal of Vascular and Endovascular Surgery
关键词
下肢动脉硬化闭塞症
256层CT血管造影
数字减影血管造影
诊断效能
arteriosclerosis obliterans of lower extremity
256-slice CT angiography
digital subtraction angiography
diagnostic efficacy
