双源CT血管成像对糖尿病与非糖尿病下肢动脉粥样硬化的对照研究  

Comparison of lower extremity atherosclerosis between diabetic and non-diabetic patients using dual-source CTA

作　　者：杨金钢[1] 吴佳玲[1] 莫小军[1] 余香[1] 顾明[1] 

机构地区：[1]中国人民解放军成都军区总医院放射科,四川成都610083

出　　处：《实用放射学杂志》2015年第1期61-65,共5页Journal of Practical Radiology

摘　　要：目的：探讨双源 CT 血管成像评价糖尿病与非糖尿病患者下肢动脉粥样硬化病变的差异。方法行双源 CT 下肢血管成像患者87例，其中糖尿病组30例，非糖尿病组57例，对2组间动脉粥样硬化斑块类型、管腔狭窄程度、分布和累及范围进行对照研究。结果糖尿病组下肢血管共540节段，检出动脉粥样硬化血管342节段（63.3%），非糖尿病组下肢血管共1026节段，检出动脉粥样硬化500节段（48.7%），糖尿病组动脉粥样硬化发生率明显高于非糖尿病组（P 〈0.05）。2组患者间斑块类型均以钙化斑为主，糖尿病组混合斑块发生率（35.6%）高于非糖尿病组（28.4%）（P 〈0.05）。狭窄类型糖尿病组以轻~中度狭窄（〈70%）为主，其中糖尿病组血管完全闭塞率（9.1%）较非糖尿病组（17.0%）低（P 〈0.05）。糖尿病组动脉粥样硬化斑块主要分布于膝关节以下中小动脉，非糖尿病组斑块主要分布于膝关节平面以上近端大动脉。糖尿病组动脉管壁受累较弥漫，管壁Ⅳ度（75%~100%）受累较非糖尿病组高（P〈0.05）。结论双源 CT 血管成像显示糖尿病组下肢动脉粥样硬化发病率较非糖尿病组高，主要累及膝关节以下中小动脉，病变范围弥漫、呈多节段分布，混合斑块比例较非糖尿病组高，糖尿病动脉粥样硬化斑块主要引起管腔轻~中度狭窄。Objective To evaluate the differences of the lower extremity atherosclerosis between patients with and without type 2 diabetes using dual-source CT angiography.Methods Dual-source CT angiography of lower extremity was performed in 87 patients with （n=30）or without （n= 57 ）diabetes.Extent of luminal stenosis,and the type,distribution and range of the plaques were compared.Results 342 plaques in 540 segments （63.3%）in diabetic patients,and 500 plaques in 1 026 segments （48.7%）in non-diabetic ones were detected respectively.Compared with non-diabetic patients,the diabetic ones had a higher overall incidence of plaques （P 〈0.05）.Calcified plaques were the most common in both kinds of patients,and the incidence of mixed plaques was high-er in diabetic patients than that in non-diabetic ones （35.6 % vs.28.4%,P 〈0.05）.Light to moderate stenosis occurred in most diabetic patients,and fewer occlusion was found compared with non-diabetic ones （9.1% vs.1 7.0%,P 〈0.05）.The most common sites of the plaques in diabetic patients were located at distal small arteries below the knee.However,those were located at proximal arteries above the knee for non-diabetic ones.The involvement of atherosclerosis in diabetic patients was more diffused,and the de-gree of Ⅳ （75%-100%）was higher than that in non-diabetic ones （P 〈0.05）.Conclusion Atherosclerosis in lower extremity on dual-source CT angiography is very common in diabetic patients with multi-segmental,diffused,non-obstructive involvement of dis-tal small arteries below the knee.

关 键 词：计算机体层成像 动脉粥样硬化 糖尿病 血管造影术 下肢动脉 

分 类 号：R814.42[医药卫生—影像医学与核医学] R543.5[医药卫生—放射医学]