16层螺旋CT血管造影对评估糖尿病足病患者下肢血管病变的应用

Application of MSCTA for evaluating lower extremity angiopathy in diabetic foot patients

目的利用16层螺旋CTCTA评估不同级别糖尿病足(DF)下肢动脉病变特点,为DF的诊断、治疗及预后评估提供新的影像学方法。方法对42例DF患者行下肢动脉CTA检查,0～2级DF归为轻度组;3～4级DF归为重度组,另外选取同龄糖尿病(DM)患者20例及无糖尿病者(NDM)18例作为对照组。结果重度DF组下肢动脉管腔截面积低于轻度组,存在统计学差异,管壁钙化、斑块及侧支循环均较轻度组明显,并与DF的级别存在相关性,其中斑块的相关性最强。DF组患侧下肢动脉狭窄程度与对侧比较无统计学差异。DF组、DM组及NDM组下肢动脉管腔截面积比较,存在统计学差异。结论16层螺旋CTCTA检查,为评估DF下肢动脉病变提供了一种安全、无创、准确的检查方法,具有重要临床价值,应作为治疗前的常规检查。

Objective To determine the applied value of 16-slice spiral computed tomography angiography （MSCTA） for evaluating the features of lower extremity angiopathy in diabetic foot patients （DFPs） and to provide a new imaging method for the diagnosis, treatment and prognostic assessment of this disease. Methods Forty-two DFPs underwent MSCTA of bilateral lower extremity. All DFPs were divided into mild disease group （stage 0-2） and serious disease group （stage 3-4） according to the severity of DF, simultaneously, age-matched 20 cases of diabetes mellitus（DM） and 18 cases of non-diabetes mellitus（NDM） were taken as control groups. Results The calibres of lower extremity arteries in serious DFP group were smaller than those in mild DFP group and there was statistic difference between two groups. The calcification and plaque of vascular wall and collateral circulation in serious DFP group were more severer that those in mild DFP group and was positive correlation with DF stage, especially with plaque severity. For DFPs, the stenosed degrees of lower extremity arteries in affected side were similar to those in intact side. Compared with NDM group, the calibres of lower extremity arteries in DFP group were significantly reduced. Conclusion MSCTA is a safe, non-invasive and accurate method for evaluating lower extremity artery disease in DFPs so that it should be taken as a routine examination.