64排螺旋CT血管造影在下肢动脉硬化闭塞症患者介入治疗中的应用研究  

Study on the application of 64-row spiral CTA in interventional therapy of patients with arteriosclerotic obliterans of lower extremity

作　　者：谢泽洲 宋海龙 Xie Zezhou;Song Hailong(Department of Vascular Surgery,Beijing Huairou Hospital,Beijing 101400,China)

机构地区：[1]北京怀柔医院血管外科,北京101400

出　　处：《中国医学装备》2024年第7期43-47,共5页China Medical Equipment

基　　金：北京市卫生健康委员会科研课题(Z20936)。

摘　　要：目的:分析64排螺旋CT血管造影在下肢动脉硬化闭塞症患者的诊断效能及介入治疗后进行筛查的应用价值。方法:回顾性分析2020年7月至2022年6月北京怀柔医院收治的76例下肢动脉硬化闭塞症患者,所有患者均行64排螺旋CT血管造影,并以数字减影血管造影检查动脉狭窄结果为“金标准”,分析下肢动脉硬化闭塞症患者动脉狭窄度、诊断效能,以及介入治疗后动脉再狭窄情况。结果:76例患者共有1238个动脉结节,64排螺旋CT血管造影结果中有1170个动脉结节与数字减影血管造影一致,一致率为94.51%,其中64排螺旋CT血管造影高估率为4.44%(55/1238),低估率为0.57%(7/1238);以“金标准”为对比,动脉狭窄中度以上准确率为91.84%,灵敏度为86.91%,特异度为93.86%,阳性预测值85.25%,阴性预测值84.61%,64排螺旋CT诊断血管造影动脉闭塞准确率为98.38%,灵敏度为85.71%,特异度为99.56%,阳性预测值94.74%,阴性预测值98.69%;76例患者经介入治疗随访1年后,经64排螺旋CT血管造影检查再狭窄率为13.16%(10/76),共有168个血管结节,64排螺旋CT血管造影诊断符合率为97.62%(164/168)。结论:采用64排螺旋CT血管造影检查可评估下肢动脉硬化闭塞症患者下肢动脉闭塞程度,具有良好的诊断效能,与数字减影血管造影有较高的一致性,有助于治疗方案的制定,且对介入治疗后再狭窄的诊断也有良好的应用价值。Objective:To analyze diagnostic efficacy of 64-row spiral computed tomography angiography(CTA)in patients with arteriosclerotic obliterans of lower extremity,and the application value of that in screen after interventional therapy.Methods:A retrospective analysis was conducted on 76 patients with arteriosclerotic obliterans of lower extremity who admitted to Beijing Huairou Hospital from July 2020 to June 2022,and all patients underwent 64-row spiral CTA.The digital subtraction angiography was used as gold standard.The degree of arterial stenosis,diagnostic efficacy and the situation of the restenosis of artery after interventional therapy of patients with arteriosclerotic obliterans of lower extremity were analyzed.Results:There were 1238 arterial nodules in 76 patients.In the results of 64-row spiral CTA,the results of 1170 arterial nodules were consistent with the results of digital subtraction angiography(94.51%).Among of them,the overestimation rate of 64-row spiral CTA was 4.44%(55/1238)and the underestimation rate of that was 0.57%(7/1238).According to the gold standard of digital subtraction angiography,the accuracy of 64-row spiral CTA was 91.84%in diagnosing the moderate and above moderate arterial stenosis,and the sensitivity,specificity,positively and negatively predictive value of that were respectively 86.91%,93.86%,85.25%and 84.61%.The accuracy,sensitivity,specificity,positively predictive value and negatively predictive value of 64-row spiral CTA were respectively 98.38%,85.71%,99.56%,94.74%and 98.69%in diagnosing arterial occlusion.After 1 year follow-up after interventional therapy,the rate of the restenosis of 76 patients was 13.16%as the examination of 64-row spiral CTA,and there was a total of 168 vascular nodules,and the diagnostic coincidence rate of 64-row spiral CTA was 97.62%(164/168).Conclusion:The 64-row spiral CTA can assess the degree of arterial occlusion of lower extremity in patients with arteriosclerotic obliterans lower extremity,which has favorable diagnostic efficacy and highe

关 键 词：64排螺旋CT血管造影 下肢动脉硬化闭塞症 介入治疗 应用研究 

分 类 号：R543.5[医药卫生—心血管疾病]