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64排螺旋CTA对糖尿病足下肢动脉病变的评估价值(1)
http://www.100md.com 2010年9月1日 徐锐 刘晓红 王瑞敏 李建龙 延宏
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     【摘要】 目的 探讨64排多层螺旋CT血管造影(MSCTA)在糖尿病足下肢动脉硬化闭塞症的临床应用价值。方法 对30例临床疑有下肢动脉硬化闭塞症患者行64层MSCTA,检查后2周内均行DSA检查。以DSA表现为金标准,评估MSCTA的临床价值。CT技术采用最大密度投影(MIP)、容积再现(VRT)及多平面重建(MRP)技术。结果 30病例共420支动脉纳入本研究。对于中度及以上狭窄的血管,CTA的敏感度、特异度、准确度、阳性预测值、阴性预测值分别是97.1%、98.0%、97.6%、97.1%、98.0%。Kappa值为0.95,二者有相当可靠的一致性。结论 64排多层螺旋CT血管造影是评估下肢动脉狭窄及闭塞程度的一种可靠、无创的检查方法。CTA可为下肢动脉闭塞症提供有效的个体化诊疗方案。

    【关键词】 多层螺旋CT血管成像;糖尿病足;动脉闭塞症;下肢动脉;数字减影血管造影;介入

    Evaluation of64-detector Spiral CTA in the lowe extremity vasculardisease of diabetic foot

    XU Rui, LIU Xiao-hong,WANG Rui-min,et al.Medical Imaging Department of Rizhao People’s hospital,Shandong 276826,China

    【Abstract】 Objective To evaluate the clinical application value of 64-detector Spiral CTAin the assessment of lower extremity peripheral arteriosclerotic occlusive disease of diabetic foot.Methods 30 patients with syptomatic lower extremity peripheral arteriosclerotic occlusive disease underwent 64-slice spiral CT angiography of lower extremity arteries and they aslo underwent digital subtraction angiography two weeks later.The clinical value of MSCTA angiography was evaluate,using digital subtraction angiography as the standard reference.MIP(maximal intensity projection),VRT(volume rendering technique) and MRP(multiplanar reconstruction) were used in reconstruton of MSCTA.Results Four hundred and twenty arteries in 30 patients were included in this study.With regard to the detection of segments among lower extremity arteries that had more than mild stenosis,the sensitivity,specificity,accuracy,positive predictive value and negtive predictive value of MSCTA were 97.1%,98.0%,97.6%,97.1%、98.0%,respectively.The Kappa value was 0.95,suggesting that there was considerably reliable coherence between MSCTA and DSA.Conclusion 64-detector Spiral CTA is a reliable method for evaluating the aortoiliac and lower extremity arteries.CTA can provide an effective individual progrm of diagnostics and treatment in the assessment of lower extremity peripheral arteriosclerotic occlusive disease ......

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