二维彩超联合三维超声在下肢动脉闭塞支架置入后再狭窄中的应用价值  

Application Value of Two-dimensional Color Doppler Ultrasonography Combined with Three-dimensional Ultrasonography in Restenosis After Stent Placement of Lower Extremity Arterial Occlusion

作　　者：吕仁华 谭晋韵 范伟健 林杰 王涌 丁红 LV Renhua;TAN Jinyun;FAN Weijian;LIN Jie;WANG Yong;DING Hong(Department of Ultrasound,Huashan Hospital,Fudan University;Department of Vascular Surgery,Huashan Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院超声医学科 [2]复旦大学附属华山医院血管外科,上海200040

出　　处：《中国医学计算机成像杂志》2023年第5期572-576,共5页Chinese Computed Medical Imaging

摘　　要：目的:以数字减影血管造影(DSA)作为金标准,探讨二维彩超联合三维超声在诊断下肢动脉闭塞支架置入后再狭窄中的应用价值。方法:选取2021年7月至11月期间复旦大学附属华山医院血管外科收治的曾因下肢闭塞性动脉硬化已行支架置入术后出现支架内狭窄(ISR)可疑症状的患者18例(22条患肢),分别完成二维彩超、三维超声(3D-US)、两者联合应用及CT血管成像(CTA)检查,比较4种方法的检出率及诊断效能。结果:二维彩超、3D-US、两者联合应用及CTA对下肢动脉ISR总体诊断符合率分别为77.3%、86.4%、95.5%与90.9%。以DSA结果为金标准,4种方法经Kappa一致性检验得κ值分别为0.486、0.645、0.861与0.621 (P<0.01)。结论:二维彩超联合3D-US与DSA在下肢动脉支架内狭窄的判断上具有非常好的一致性,为准确诊断ISR提供了新的方法和依据。Purpose:Digital subtraction angiography(DSA)was used as the gold standard to investigate the application value of two-dimensional(2D)color Doppler ultrasonography combined with three-dimensional(3D)ultrasonography in the diagnosis of in-stent restenosis(ISR)after endovascular stenting of lower limb atherosclerosis obliterans(ASO).Methods:From July to November 2021,18 patients(22 limbs)with related symptoms after stenting due to lower limb ASO and treated in the Department of Vascular Surgery of Huashan Hospital,Fudan University were retrospectively collected.2D color Doppler ultrasonography,3D ultrasonography(3D-US),combination of above two and computed tomography angiography(CTA)were used to compare the detection rate and diagnostic efficiency among them.Results:The overall diagnostic coincidence rates of 2D color Doppler ultrasound,3D-US,2D color Doppler ultrasonography combined with 3D-US and CTA for limb artery ISR were 77.3%,86.4%,95.5%and 90.9%,respectively.Taking the DSA result as the gold standard,the x values obtained by the Kappa consistency test of the four methods were 0.486,0.645,0.861 and 0.621,respectively(P<0.01).Conclusion:It is suggested that 2D color Doppler ultrasonography combined with 3D-US and DSA have great consistency in the diagnosis of ISR of lower limb arteries,which provides a new method and evidences for the diagnosis of ISR.

关 键 词：下肢 闭塞性动脉硬化症 支架内再狭窄 三维超声 能量多普勒 

分 类 号：R445.1[医药卫生—影像医学与核医学]