能谱CTA与NCE-MRA联合应用在老年2型糖尿病下肢血管病变中的诊断价值分析  

Evaluation the Diagnostic Value of Spectral CTA Combined with NCE-MRA in Lower Extremity Vascular Disease in Elderly Patients with Type 2 Diabetes Mellitus

作　　者：陈琰 赖苏梅 刘佳 CHEN Yan;LAI Sumei;LIU Jia(Department of Radiology,Longyan People's Hospital,Longyan 364000,Fujian,China)

机构地区：[1]龙岩人民医院放射科,福建龙岩364000

出　　处：《糖尿病新世界》2025年第4期173-176,共4页Diabetes New World

摘　　要：目的 探讨能谱CT血管造影(computed tomography angiography,CTA)与非对比增强磁共振血管成像(non-contrast enhanced magnetic resonance angiography,NCE-MRA)联合应用在老年2型糖尿病(type 2 diabetes mellitus,T2DM)下肢血管病变诊断中的价值。方法 选取2021年1月—2024年8月在龙岩人民医院就诊的217例疑似老年T2DM并发下肢血管病变患者,均接受能谱CTA与NCE-MRA扫描。以临床综合诊断为金标准,对比评估不同诊断方法的诊断结果和诊断效能。结果 经临床综合诊断检出阳性143例,阴性74例,能谱CTA诊断kappa值为0.740,NCE-MRA诊断kappa值为0.726,能谱CTA联合NCE-MRA诊断kappa值为0.949。联合诊断的灵敏度、特异度、准确度、阳性预测值、阴性预测值均高于能谱CTA、NCE-MRA单一诊断,差异均有统计学意义(P均<0.05)。结论 能谱CTA联合NCE-MRA应用在老年T2DM下肢血管病变的诊断中,能够显著提高诊断的准确度、灵敏度、特异度,为临床提供更为可靠的诊断依据。Objective To investigate the value of spectral computed tomography angiography(CTA) combined with non-contrast enhanced magnetic resonance angiography(NCE-MRA) in the diagnosis of lower extremity vascular disease in elderly patients with type 2 diabetes mellitus(T2DM).Methods A total of 217 elderly patients with suspected T2DM complicated with lower extremity vascular disease who were treated in Longyan People's Hospital from January 2021 to August 2024 were selected.All patients underwent spectral CTA and NCE-MRA scans.With clinical comprehensive diagnosis as the gold standard,the diagnostic results and diagnostic efficacy of different diagnostic methods were compared and evaluated.Results 143 positive cases and 74 negative cases were detected by clinical comprehensive diagnosis.The kappa value of spectral CTA was 0.740,the kappa value of NCE-MRA was 0.726,and the kappa value of energy spectrum CTA combined with NCE-MRA was 0.949.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of combined diagnosis were higher than those of single diagnosis of spectral CTA and NCE-MRA,and the differences were statistically significant(all P<0.05).Conclusion The application of spectral CTA combined with NCE-MRA in the diagnosis of lower extremity vascular disease in elderly T2DM can significantly improve the accuracy,sensitivity and specificity of diagnosis,and provide more reliable diagnostic basis for clinical practice.

关 键 词：能谱CT下肢血管造影 非对比增强磁共振血管成像 慢性2型糖尿病 下肢血管病变 准确度 

分 类 号：R587.1[医药卫生—内分泌]