摘要
目的 探讨低剂量CT血管造影(CTA)对下肢动脉硬化闭塞症(LEASO)患者介入术后血管再狭窄的诊断价值。方法 回顾性分析接受介入治疗的LEASO患者75例为研究对象,常规随访1年后根据数字减影血管造影(DSA)将患者分为再狭窄组(血管狭窄≥50%)19例和非再狭窄组56例。采用低剂量CTA扫描和多种后处理技术重组下肢动脉三维图像,记录扫描长度(L)、容积CT剂量指数(CTDIvol)和剂量长度乘积(DLP),计算有效剂量(ED)值。以DSA为金标准,评价CTA对LEASO患者介入术后血管再狭窄的诊断价值。结果 两组CTA参数L、CTDIvol、DLP、ED值和图像质量比较,差异均无统计学意义(t分别=0.65、0.56、1.12、0.82,Z=-0.37,P均>0.05)。CTA诊断血管再狭窄24例,准确率为80.00%,灵敏度为73.68%,特异度为82.14%,阳性预测值为58.33%和阴性预测值为90.20%。CTA显示再狭窄程度与DSA具有较高的一致性(Kappa=0.90)。结论 LEASO介入术后仍有较高的支架内再狭窄发生率,低剂量CTA对下肢动脉再狭窄有较好的诊断效能,同时图像质量较好,射线和对比剂暴露减少,安全性更高。
Objective To investigate the clinical value of low-dose CT angiography(CTA)in the diagnosis of resteno⁃sis for patients with lower extremity arteriosclerosis obliterans(LEASO)after interventional therapy.Methods Totally 75 patients with LEASO received interventional therapy were enrolled in the retrospective study.According to the result of digital subtraction angiography(DSA)after one year follow-up,they were divided into restenosis group(vascular steno⁃sis≥50%)with 19 cases and non-restenosis group with 56 cases.Low dose CTA scanning and various post-processing techniques were used to reconstruct the three-dimensional images of lower limb arteries,then the scanning length(L),volume CT dose index(CTDIvol)and dose length product(DLP)were recorded,the effective dose(ED value)was cal⁃culated.The diagnostic value of CTA for vascular restenosis in LEASO patients after interventional surgery was evaluated.Results There was no difference in CTA parameters including L,CTDIvol,DLP,ED value and image quality(t=0.65,0.56,1.12,0.82,Z=-0.37,P>0.05).CTA diagnosed 24 cases of restenosis,the accuracy was 80.00%,sensitivity was 73.68%,specificity was 82.14%,positive predictive value was 58.33%and negative predictive value was 90.20%.CTA showed a high consistency of the degree of restenosis with DSA(Kappa=0.90).Conclusion There is still a high inci⁃dence of instent restenosis after LEASO intervention,low dose CTA has a good diagnostic efficacy for lower extremity ar⁃terial restenosis.At meanwhile,the image quality is good,the exposure of X-ray and contrast agent is reducing,so the safety is higher.
作者
陈君
唐建红
方萍
CHEN Jun;TANG Jianhong;FANG Ping(Department of Radiology,Jinhua People's Hospital,Jinhua 321000,China)
出处
《全科医学临床与教育》
2023年第12期1067-1070,共4页
Clinical Education of General Practice
基金
金华市科技计划项目(2022-4-162)。
关键词
下肢动脉硬化闭塞症
血管内介入
低剂量
CT血管造影
再狭窄
lower extremity arteriosclerosis oblit⁃erans
intravascular intervention
low dose
CT angiography
restenosis
