CT血管成像与数字减影血管造影对下肢闭塞性动脉硬化的诊断价值  

Diagnostic Value of CT Angiography and Digital Subtraction Angiography in Lower Extremity Arteriosclerosis Obliterans

作　　者：任立刚 Ren Ligang(Surgery Department,Tianjin Jinnan Hospital,Tianjin 300350,China)

机构地区：[1]天津市津南医院外科,天津300350

出　　处：《医疗装备》2022年第17期29-32,共4页Medical Equipment

摘　　要：目的探讨CT血管成像(CTA)与数字减影血管造影(DSA)对下肢闭塞性动脉硬化(ASO)的诊断价值。方法选取2020年2月至2021年10月天津市津南医院收治的58例疑似下肢ASO患者,征得患者同意后均进行CTA和DSA检查;以DSA检查结果为金标准,分析下肢CTA动脉树图像并评估其对ASO的诊断价值。结果共统计796段下肢动脉血管图像,以DSA检查结果为金标准,CTA诊断血管狭窄程度的符合率为96.73%(770/796),Kappa一致性检验显示,两种检查方法诊断的一致性较好(Kappa=0.937)。58例疑似下肢ASO患者经DSA确诊48例,CTA诊断下肢ASO的灵敏度、特异度和准确度分别为93.75%、80.00%和91.38%,漏诊3例,误诊2例,漏诊和误诊的原因主要为静脉显影和(或)动脉部分节段显影不良。结论CTA和DSA均能充分获取下肢动脉狭窄程度的相关信息,两者对下肢ASO的诊断效果接近,且各具优势和不足,临床中应灵活应用。Objective The diagnostic value of CT angiography(CTA)and digital subtraction angiography(DSA)in lower extremity arteriosclerosis obliterans(ASO)were investigated.Methods 58 patients with suspected lower extremity ASO treated in Tianjin Jinnan Hospital from February 2020 to October 2021 were selected and examined by CTA and DSA with the consent of the patients.Taking the DSA results as the gold standard,the CTA arterial tree images of lower extremity was analyzed and their diagnostic value of ASO were evaluated.Results A total of 796 lower extremity arterial images were counted.Taking the DSA results as the gold standard,the coincidence rate of lower extremity CTA in the diagnosis of vascular stenosis was 96.73%(770/796).Kappa consistency test showed that the diagnosis consistency of the two methods was good(Kappa=0.937).Among 58 suspected lower extremity ASO patients,48 cases were confirmed by DSA.The sensitivity,specificity and accuracy of CTA in the diagnosis of lower extremity ASO were 93.75%,80.00%and 91.38%respectively.3 cases of ASO were missed and 2 cases of ASO were misdiagnosed.The main causes of missed diagnosis and misdiagnosis were poor venous imaging and/or partial arterial segmental imaging.Conclusions Both lower extremity CTA and DSA can fully obtain the relevant information of the degree of lower extremity arterial stenosis.Their diagnostic effects on ASO are similar,and they have their own advantages and disadvantages.They should be applied flexibly in clinical practice.

关 键 词：下肢闭塞性动脉硬化 CT血管成像 数字减影血管造影 狭窄程度 一致性 

分 类 号：R587.2[医药卫生—内分泌]