糖尿病足下肢动脉病变的CTA及MRA影像特点及危险因素分析  

Imaging Characteristics of CTA and MRA and Risk Factors of Lower Extremity Arterial Lesions in Patients with Diabetic Foot

作　　者：余宏建[1] 郭学军[1] 陈在中[1] 阮继银[1] 张辉[1] 

机构地区：[1]北京大学深圳医院影像中心微创介入科,广东深圳518036

出　　处：《中国CT和MRI杂志》2017年第3期122-124,131,共4页Chinese Journal of CT and MRI

基　　金：深圳市科创委基础研究项目,项目编号:JCYJ2014 0415162338788

摘　　要：目的分析糖尿病足(DF)下肢动脉病变的CT血管造影(CTA)、磁共振血管造影(MRA)影像学特点及危险因素。方法以本院2014年3月-2016年3月确诊的57例糖尿病足下肢动脉病变患者为研究对象,均接受血管数字减影(DSA)、CTA、MRA检查,以DSA为金标准,比较CTA、MRA诊断敏感度、特异度及准确度;同时选择同期确诊的50例DF非下肢动脉病变患者为对照组,单因素及Logistic多因素回归分析DF下肢动脉病变危险因素。结果 CTA对膝下动脉、总体诊断敏感度分别为64.13%、90.78%,准确度分别为88.89%、94.72%,均显著低于MRA的98.91%、98.39%,97.66%、98.05%,差异有统计学意义(P<0.05);CTA、MRA对膝上动脉诊断敏感度、特异度、准确度比较均无显著差异(P>0.05);Logistic多因素回归分析显示DF下肢动脉病变独立危险因素包括高血压、体重指数(BMI)、餐后2h血糖(2h PG)。结论 CTA、MRA对DF下肢动脉病变诊断均有一定的价值,但MRA对下膝动脉病变诊断敏感度、准确度显著高,同时需对患者血压、血糖等指标监测,以了解DF发生、发展情况。Objective To analyze the imaging characteristics of CT angiography （CTA） and magnetic resonance angiography （MRA） and risk factors of lower extremity arterial lesions in patients with diabetic foot （DF）. Methods Fifty-seven patients with DF and lower extremity arterial lesions treated in our hospital between March 2014 and March 2016 were selected as study subjects. All patients underwent digital subtraction angiography （DSA）, CTA and MRA. With DSA as the golden standard, the diagnostic sensitivities, specificities and accuracy rates were compared between CTA and MRA. Another 50 patients with DF and without lower extremity arterial lesions confirmed in the same period were selected as the control group. The risk factors of lower extremity arterial lesions in patients with DF were analyzed by univariate and multivariate Logistic regression analysis.Results The sensitivities and accuracy rates of CTA in the diagnosis of infrapoptiteal artery and the overall condition （64.13%, 90.78% and 88.89%, 94.7%） were significantly lower than those of MRA （98.91%. 98.39% and 97.66%, 98.05%） （P〈0.05）. There were no significant differences in the sensitivities, specificities and accuracy rates between CTA and MRA in the diagnosis of infrapopliteal artery （P〉0.05）; multivariate Logistic regression analysis showed that the independent risk factors of lower extremity arterial lesions in patients with DF included hypertension, body mass index （BMI） and postprandial 2h blood glucose （2hPG）. Conclusion Both of CTA and MRA are of certain value in the diagnosis of lower extremity arterial lesions in patients with DF but the diagnostic sensitivity and accuracy of MRA are significantly higher. Meanwhile, the blood pressure, blood glucose and other indicators of patients need to be monitored to understand the occun＇ence and development of DF.

关 键 词：糖尿病足 下肢动脉病变 CT血管造影 

分 类 号：R781.64[医药卫生—口腔医学]