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CTA诊断糖尿病下肢动脉临床分期及下肢动脉狭窄程度的应用价值
刘衡,冉启胜,邓洋,夏传江
0
(陆军军医大学大坪医院野战外科研究所放射科)
摘要:
目的 探讨CT血管造影(CTA)诊断糖尿病下肢动脉临床分期及下肢动脉狭窄程度的应用价值。方法 选取2015年1月~2017年8月经我院临床诊断为糖尿病下肢动脉疾病的患者89例,所有患者均进行CTA与数字减影血管造影(DSA)检查。整理89例患者DSA与CTA重建图像,由两名经验丰富的放射科诊断医师共同评估观察DSA与CTA重建图像,以DSA检查结果为金标准,对CTA对下肢动脉狭窄程度诊断的灵敏度、特异性及准确度进行计算,并分析CTA对诊断糖尿病下肢动脉临床分析的应用价值。结果 CTA与DSA检查结果一致性较好,以DSA检查结果为金标准,CTA诊断膝上动脉血管狭窄≥50%的灵敏度为97.23%、特异性为97.15%、准确度为97.13%、阳性预测值为94.02%及阴性预测值为97.89%,Kappa=0.945;CTA诊断膝下血管狭窄≥50%诊断的灵敏度为96.12%、特异性为92.05%、准确度为94.13%、阳性预测值为92.22%及阴性预测值为96.34%,Kappa=0875;CTA诊断足动脉血管狭窄的灵敏度为69.21%、特异性为90.95%、准确度为89.03%、阳性预测值为72.34%及阴性预测值为88.86%,Kappa=0.657。结论 CTA诊断糖尿病下肢动脉疾病,能对下肢动脉及其病变区进行直观、全面、清晰的准确显示,有利于影像医生对狭窄程度进行准确分级,可为临床对糖尿病下肢动脉疾病术前评价和筛选提供重要诊断依据。
关键词:  CTA  糖尿病  糖尿病肾病  下肢动脉  分期  狭窄程度
DOI:
基金项目:重庆市科委自然科学基金(CSTC2005BB5310)
Application of CTA in diagnosis of lower extremity arterial staging and lower extremity arterial stenosis in diabetic patients
LIU Heng,RAN Qisheng,DENG Yang,XIA Chuanjiang
(Radiology Department, Institute of Field Surgery, Daping Hospital, Army Medical University)
Abstract:
Objective To investigate the application effect of CT angiography (CTA) in diagnosis of lower extremity arterial staging and lower extremity arterial stenosis in diabetic patients. Methods 89 patients with diabetic lower extremity arterial disease diagnosed in our hospital from January 2015 to August 2017 were selected. All patients underwent CTA and digital subtraction angiography (DSA). The CTA and DSA images of 89 patients were reconstructed and evaluated by two experienced radiology diagnosticians. Using DSA test results as the standard reference, the sensitivity, specificity, accuracy, and the application value of CTA in the diagnosis of lower extremity arterial stenosis were analyzed. Results The consistency between CTA and DSA test results was similar. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of CTA in detecting the artery stenosis degree above the knee segment were 97.23%, 97.15%, 97.13%, 94.02% and 97.89%, Kappa=0.945. Those below knee segment were 96.12%, 92.05%, 94.13%, 92.22% and 9634%, Kappa=0.875. Those of pedal artery were 69.21%, 90.95%, 89.03%, 72.34% and 88.86%, Kappa=0.657. Conclusion CTA diagnosis of lower extremity arterial disease in diabetes can provide an intuitive, comprehensive, clear and accurate display of the lesions, which is helpful for the radiologist to accurately classify the degree of stenosis, and provides important clinical preoperative evaluation and screening for diabetic arterial disease of the lower limbs.
Key words:  CTA  Diabetes  Diabetic nephropathy  Artery of lower extremity  Staging  Stenosis

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