计算机断层扫描血管造影对下肢动脉硬化性闭塞症的诊断价值  

Diagnostic value of computed tomography angiography in patients with lower extremity occlusive vascular disease

作　　者：王春燕 杨彦林[2] 吴国良[2] 田少勇[2] 赵鹏飞 Wang Chunyan;Yang Yanlin;Wu Guoliang;Tian Shaoyong;Zhao Pengfei(Department of Medical Imaging,Hengshui Hospital of Traditional Chinese Medicine,Hengshui 053000,Hebei,China;Department of Intervention,Halison International Peace Hospital,Hengshui 053000,Hebei,China)

机构地区：[1]衡水市中医医院医学影像科,河北衡水053000 [2]哈励逊国际和平医院介入科,河北衡水053000

出　　处：《血管与腔内血管外科杂志》2023年第6期721-725,共5页Journal of Vascular and Endovascular Surgery

基　　金：河北省医学科学研究计划项目(20200407)。

摘　　要：目的探讨计算机断层扫描血管造影(CTA)对下肢动脉硬化性闭塞症的诊断价值。方法收集2019年1月至2021年2月哈励逊国际和平医院收治的200例疑似下肢动脉硬化性闭塞症患者的临床资料,所有患者均于治疗前进行了CTA和数字减影血管造影(DSA)检查。以DSA检查结果为金标准,评估CTA检查对下肢动脉硬化性闭塞症的诊断价值。所有下肢动脉硬化性闭塞症患者均进行药物球囊或者支架植入治疗,观察患者治疗后的临床疗效及影像学表现。结果治疗前,CTA检查结果显示,下肢动脉硬化性闭塞症患者194例;DSA检查结果显示,下肢动脉硬化性闭塞症患者195例。CTA检查诊断下肢动脉硬化性闭塞症的灵敏度为97.95%(191/195),特异度为40.00%(2/5),阳性预测值为98.45%(191/194),阴性预测值为33.33%(2/6)。两种检查方式对下肢动脉硬化性闭塞症的诊断具有较高的一致性(Kappa=0.892)。治疗后,下肢动脉硬化性闭塞症患者的病变股动脉管径、病变股动脉横断面积、血管周围附着肌肉计算机断层扫描(CT)值及血管周围侧支循环数目均较治疗前明显增加(P﹤0.01)。结论CTA检查对下肢动脉硬化性闭塞症的诊断灵敏度较高,与DSA检查的一致性较好,有利于术前的准确诊断、手术治疗策略的选择及术后疗效的评估。Objective To explore the diagnostic value of computed tomography angiography(CTA)in patients with lower extremity occlusive vascular disease.Method Clinical data of 200 patients with suspected lower extremity occlusive vascular disease admitted in Halison International Peace Hospital from January 2019 to December 2021 were collected.All patients underwent CTA and digital subtraction angiography(DSA)before treatment.The diagnostic value of CTA in patients with lower extremity occlusive vascular disease was evaluated by using DSA results as the gold standard.All patients with lower extremity occlusive vascular disease received drug-coated balloon or stent implantation,the clinical efficacy and imaging manifestation were observed after treatment.Result Before treatment,CTA results showed 194 cases of lower extremity occlusive vascular diseases and DSA showed 195 cases.The diagnosis sensitivity,specificity,positive predictive value and negative predictive value of CTA in the diagnosis of lower extremity occlusive vascular disease was 97.95%(191/195),40.00%(2/5),98.45%(191/194)and 33.33%(2/6),respectively.The two examination methods have a high consistency in the diagnosis of lower extremity occlusive vascular disease(Kappa=0.892).After treatment,the involved femoral arterial diameter,involved femoral arterial cross-sectional area,computed tomography(CT)value around the blood vessel and blood vessel collateral circulation number were remarkably increased significantly compared with those before treatment(P<0.01).Conclusion CTA has higher diagnostic sensitivity of lower extremity occlusive vascular disease and good consistency with DSA,which can be used for preoperative diagnosis,intraoperative treatment selection and postoperative efficacy evaluation.

关 键 词：计算机断层扫描血管造影 球囊 下肢动脉硬化性闭塞症 数字减影血管造影 诊断价值 

分 类 号：R543[医药卫生—心血管疾病]