CT血管成像诊断下肢动脉硬化闭塞症诊断的应用价值

The Value of CT Angiography in the Diagnosis of Lower Extremity Arteriosclerosis Obliterans

目的探讨CT血管成像诊断下肢动脉硬化闭塞症的临床价值。方法选择本院2017年1月-2018年6月收治的64例下肢动脉硬化闭塞症患者,均进行CT血管成像(CTA)与数字减影血管造影(DSA)检查。比较2种检查方法对下肢各节段狭窄程度的一致率、对代偿侧支分级的一致率,以DSA为金标准计算CTA诊断中度及以上狭窄节段的敏感度、特异度与符合率。结果64例患者共统计了1004个节段。CTA诊断结果中共968个节段与DSA结果一致,一致率96.41%,Kappa检验为0.979,一致性较高。DSA检查结果显示,1004个节段中,中度及以上狭窄共253段。其中CTA共诊断出262段,敏感度为91.30%(231/253),特异度95.87%(720/751),符合率94.72%(951/10004)。CTA对60例患者的代偿侧支分级的诊断与DSA一致,一致率93.75%(60/64),Kappa检验为0.986,一致性高。结论CTA可全面而准确地评估下肢动脉硬化闭塞症患者的动脉狭窄情况与侧支代偿情况,是一种无创、快速、准确的检查方法,值得推广。

Objective To investigate the clinical value of CT angiography in the diagnosis of lower extremity arteriosclerosis obliterans.Methods Sixty-four patients with lower extremity arteriosclerosis obliterans admitted to our hospital from January to May 2018 were enrolled in the study.The CT angiography(CTA)and digital subtraction angiography(DSA)were performed.The consistency rate of the two kinds of examination methods for the degree of stenosis of the lower limbs and the consistency rate of the collaterals of the compensated collaterals were compared between the two methods.The sensitivity,specificity and coincidence rate of the moderate and upper stenosis segments by CTA were calculated,DSA were taken as the gold standard.Results A total of 1004 segments were counted in 64 patients.The total number of 968 segments in the CTA diagnosis was consistent with the DSA results,with a consensus rate of 96.41%and a Kappa value of 0.979.The results of DSA examination showed that there were 253 segments of moderate and severe stenosis in 1004 segments.Among them,262 segments were diagnosed by CTA,the sensitivity was 91.30%(231/253),the specificity was 95.87%(720/751),and the coincidence rate was 94.72%(951/10004).The diagnosis of compensatory collateral grading in 60 patients was consistent with DSA.The agreement rate was 93.75%(60/64),and the Kappa test was 0.986.The agreement was high.Conclusion The CTA can comprehensively and accurately assess the arterial stenosis and compensatory collaterals in patients with lower extremity arteriosclerosis obliterans.It is a non-invasive,rapid and accurate examination method,which is worthy of promotion.