彩色多普勒超声与超声造影诊断糖尿病足胫后动脉病变的对比研究  

Diabetes Posterior Tibial Artery Lesion by Color Doppler Ultrasound and Contrast-Enhanced Ultrasound

作　　者：梁彤[1] 任杰[2] 梁峭嵘[1] 刘照宏[1] 

机构地区：[1]广州中医药大学附属佛山市中医院超声科,广东省佛山市528000 [2]中山大学附属第三医院超声科

出　　处：《中国超声医学杂志》2013年第4期358-361,共4页Chinese Journal of Ultrasound in Medicine

基　　金：广东省医学科研基金立项(No.B2011305)

摘　　要：目的比较彩色多普勒超声(CDFI)和超声造影评价糖尿病足下肢动脉病变的应用价值。方法对36例糖尿病足72支胫后动脉分别进行CDFI干超声造影检查,计算狭窄率并与数字减影血管造影(DSA)作对照。结果以DSA结果作为标准,36例患者72支胫后动脉,狭窄程度分级:0级2支,Ⅰ级7支,Ⅱ级21支,Ⅲ级19支,血管闭塞23支。CDFI诊断结果与IDSA对比Spearman等级相关系数为0.834 3,Kappa值=0.600 0(P=0.000 0),超声造影结果与DSA对比Spearman等级相关系数为0.970 8,Kappa值=0.905 0(P=0.000 0。另外,CDFI高估了13支、低估了6支血管的狭窄程度;而超声造影仅高估了3支、低估了2支血管的狭窄程度。结论 CDFI是临床诊断糖尿病足下肢动脉病变的首选方法,而对其诊断困难的病例,超声造影可较CDFI获得更丰富的诊断信息,是CDFI有益的补充。Objective To assess the application value of diagnosis of diabetes foot posterior tibial artery lesion by Color Doppler Flow Imaging（CDFI） and contrast-enhanced ultrasonography （CEUS）. Methods 36 patients 72 diabe- tes foot posterior tibial arteries underwent CDFI and CEUS examinations. Stenosis was calculated and a contrast was made with DSA. Results Taking result of DSA as the criteria, the stenosis of 72 diabetes posterior tibial arteries, was classified into the following grades： Grade 0：2, Grade Ⅰ ：7, Grade Ⅱ ：21, GradeⅢ：19, and 23 arteries suffered vascularocclusion. After comparing the diagnostic result of CDFI with that of DSA, the Spearman coefficient of rank correlation is 0. 834 3,Kappa value：0. 600 0（P=0. 000 0）, and comparison between CEUS and DSA results show that the Spearman coefficient of rank correlation is 0. 970 8,Kappa value=0. 905 0（P=0. 000 0）. Hence it is revealed that CEUS is more consistent with DSA in application of arteriarctia and vascularocclusion judgment. Besides, CDFI overrated the stenosis of 13 and underrated that of 6 arteries. By contrast, the overrated and underrated arteries when using CEUS were only 3 and 2 respectively. Conclusions CDFI is the primary option for clinical diagnosis of diabetes foot posterior tibial artery lesion, whereas for those cases that are hard to be diagnosed relying on CDFI, CEUS may offer more diagnostic information, well supplementing CDFI.

关 键 词：多普勒 超声检查 造影剂 糖尿病足 胫后动脉 

分 类 号：R445.1[医药卫生—影像医学与核医学] R587.2[医药卫生—诊断学]