多层螺旋计算机断层扫描血管成像、数字减影血管造影及彩色多普勒血流图在糖尿病伴下肢动脉硬化闭塞症中的应用价值对比  

Comparison of application value of multislice spiral computed tomography angiography,digital subtraction angiography and color Doppler flow imaging in diabetes with lower extremity arteriosclerosis obliterans

作　　者：李林[1] 吕彦朋 董鑫昌[1] 狄长安[2] Li Lin;Lyu Yanpeng;Dong Xinchang;Di Chang'an(Department of General Surgery,Beijing Pinggu Hospital,Beijing 101200,China;Department of Vascular Surgery,Beijing Pinggu Hospital,Beijing 101200,China)

机构地区：[1]北京市平谷区医院普外科,北京101200 [2]北京市平谷区医院血管外科,北京101200

出　　处：《血管与腔内血管外科杂志》2022年第10期1230-1235,共6页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨多层螺旋计算机断层扫描血管成像(MSCTA)、数字减影血管造影(DSA)及彩色多普勒超声(CDFI)在糖尿病伴下肢动脉硬化闭塞症(ASO)诊断中的影像学特点及诊断价值。方法收集2016年10月至2021年7月于北京市平谷区医院首次接受下肢动脉检查及治疗的286例糖尿病患者的MSCTA、DSA、CDFI影像学资料,以DSA检查结果为诊断糖尿病伴下肢ASO的金标准,分析MSCTA、CDFI检查对糖尿病伴下肢ASO的诊断效能。结果286例糖尿病患者均顺利完成MSCTA、CDFI扫描,共获取1449个动脉节段,包括膝上动脉1110个,膝下动脉339个。DSA检查结果显示,阴性126个,阳性1323个。在1449个动脉节段中,MSCTA检查对糖尿病伴下肢ASO患者腓动脉狭窄程度的诊断灵敏度、特异度、准确度均高于CDFI检查(P<0.05)。一致性检验结果显示,MSCTA检查对肾下腹主动脉、腓动脉、足背动脉、足底动脉的诊断结果与DSA检查结果具有较高的一致性(Kappa=0.847、0.828、0.922,0.799,P<0.01)。CDFI检查对足背动脉的诊断结果与DSA检查结果具有较高的一致性(Kappa=0.922,P<0.01)。结论与CDFI检查相比,MSCTA检查可以更加清晰地显示糖尿病伴下肢ASO患者的动脉病变长度和动脉狭窄程度,其对肾下腹主动脉、腓动脉、足背动脉、足底动脉狭窄程度的诊断效能更接近DSA检查结果,可以作为糖尿病伴下肢ASO的术前筛查和评估手段。Objective To investigate the imaging characteristics and diagnostic value of multislice spiral computed tomography angiography(MSCTA),digital subtraction angiography(DSA)and color Doppler flow imaging(CDFI)in diabetic lower extremity arteriosclerosis obliterans(ASO).Method MSCTA and CDFI imaging data of 286 patients with diabetes with underwent lower extremity artery examination and treatment for the first time in Beijing Pinggu Hospital from October 2016 to July 2021 were collected,and the DSA examination results were used as the gold standard for the diagnosis of diabetic lower extremity ASO,the diagnostic efficacy of MSCTA and CDFI in the diagnosis of diabetic lower extremity ASO was analyzed.Result A total of 286 diabetes patients with lower extremity ASO successfully completed MSCTA and CDFI scans,and 1449 arterial segments were included for analysis,including 1110 superior genicular arteries and 339 inferior knee arteries.DSA results showed that 126 were negative and 1323 were positive.The sensitivity,specificity and accuracy of MSCTA in diagnosing the degree of peroneal artery stenosis in diabetes patients with lower extremity ASO were higher than those of CDFI in 1449 arterial segments(P<0.05).Consistency test results showed that the diagnostic results of MSCTA examination on subrenal abdominal aorta,peroneal artery,dorsal foot artery and plantar artery were highly consistent with DSA examination results(Kappa=0.847,0.828,0.922,0.799,P<0.01).The results of CDFI examination on the diagnosis of the dorsal foot artery were highly consistent with the results of DSA examination(Kappa=0.922,P<0.01).Conclusion Compared with CDFI,MSCTA can more clearly show the the length of arterial lesions and the degree of arterial stenosis in diabetes patients with lower extremity ASO.Among them,the diagnosis results of the subrenal abdominal aorta,peroneal artery,and dorsal foot artery and plantar artery are closer to the results of DSA,which can be used as a preoperative screening and evaluation method for diabetes with low

关 键 词：糖尿病 下肢动脉硬化闭塞症 多层螺旋计算机断层扫描血管成像 数字减影血管造影 彩色多普勒超声 

分 类 号：R543[医药卫生—心血管疾病]