多层螺旋CT下肢动脉CTA+足部灌注成像对于糖尿病足部病变的影像诊断价值  

Multi-slice Spiral CT Lower Extremity Arterial CTA + Foot Perfusion Imaging for the Diagnostic Value of Diabetic Foot Pathology

作　　者：邓开盛 李传旺 唐平太 DENG Kaisheng;LI Chuanwang;TANG Pingtai(Department of Radiology,Longyan First Hospital of Fujian Province(Longyan First Hospital Affiliated to Fujian Medical University),Longyan,Fujian Province,364000 China)

机构地区：[1]福建省龙岩市第一医院(福建医科大学附属龙岩第一医院)放射科,福建龙岩364000

出　　处：《糖尿病新世界》2021年第12期195-198,共4页Diabetes New World Magazine

摘　　要：目的探讨采用多层螺旋下肢动脉CTA联合足部灌注成像诊断糖尿病足的临床价值。方法选取2019年1月—2020年12月该院糖尿病患者105例足部病变筛查资料,检查结果显示,其中合并糖尿病足38例,非糖尿病足患者67例,比较下肢动脉状态。糖尿病足确诊患者38例,按检查方式分组,A组(下肢动脉CTA+足部灌注成像)15例,B组(下肢动脉CTA)23例,比较病变检出率、影像质量。结果糖尿病下肢动脉CTA+足部灌注成像相对于单纯下肢动脉CTA检查,不仅能够更好地显示糖尿病血管病变的主要累及膝以下胫腓动脉和动脉中膜钙化以踝部最多,趾部较少,足的背部又较趾部为多的特点,还对糖尿病足部溃疡、感染和坏疽的程度可以做出比较准确的判断。A组与B组诊断价值分析显示,检出率比较,A组高于B组,差异有统计学意义(χ^(2)=17.683,P<0.05);图像质量比较,A组[93.33%(14/15)]优于B组[73.91%(17/23)],但差异无统计学意义(P>0.05)。结论下肢动脉CTA与足部灌注成像联合诊断糖尿病足部病变,诊断价值较高,可提升检出率,图像质量较好。Objective To explore the clinical value of multi-layer spiral lower extremity arterial CTA combined with foot perfusion imaging in the diagnosis of diabetic foot.Methods The screening data of 105 cases of diabetic foot disease in the hospital from January 2019 to December 2020 were selected.The examination results showed that 38 cases of diabetic foot and 67 cases of non-diabetic foot were compared to compare the arterial status of lower extremities.Thirty-eight patients with diabetic foot were divided into groups according to the inspection method,15 cases in group A(lower extremity arterial CTA+foot perfusion imaging),and 23 cases in group B(lower extremity arterial CTA).The detection rate and image quality of the lesions were compared.Results Compared with CTA examination of lower extremity arteries alone,diabetic lower extremity arterial CTA+foot perfusion imaging can not only better show that diabetic vascular disease mainly involves the tibiofibular artery and arterial media below the knee,with the most calcifications in the ankle and fewer toes.The back of the foot is more characteristic than the toe,and the degree of diabetic foot ulcers,infection and gangrene can be more accurately judged.The diagnostic value analysis of group A and group B showed that the detection rate of group A was higher than that of group B,the difference was statistically significant(χ^(2)=17.683,P<0.05);compared with image quality,group A[93.33%(14/15)]was better than group B[73.91%(17/23)],but the difference was not statistically significant(P>0.05).Conclusion The combination of lower extremity arterial CTA and foot perfusion imaging in the diagnosis of diabetic foot lesions is of high diagnostic value,can improve the detection rate,and the image quality is better.

关 键 词：影像学检查 糖尿病足部病变 下肢动脉CTA 足部灌注成像 

分 类 号：R59[医药卫生—内科学]