CTA诊断糖尿病下肢动脉病变的临床应用评价

Evaluation on clinical application of CT angiography in the diagnosis of diabetic lower extremity artery diseases

目的探讨CTA在诊断糖尿病下肢动脉病变的应用价值。方法回顾分析了45例临床诊断2型糖尿病伴下肢动脉病变患者CTA影像,其中31例患者同期进行了血管造影检查,对比其DSA结果,评价CTA的准确性。结果 CTA可清晰显示病变的位置、范围,与DSA结果相比,总符合率为93.15%。其中髂动脉、股动脉及月国动脉符合率为100%,股深动脉为93.54%,胫前动脉96.77%,胫后动脉90.32%,腓动脉87.09%,与总符合率对比,无显著差异(P>0.05)。足背动脉符合率为77.42%,与总符合率对比有显著差异(P<0.05)。结论 CTA诊断糖尿病下肢动脉病变有较高的准确性,而且具有无创、可重复性等特点,可基本替代DSA成为首选检查方法。

Objective To evaluate the applied value of computed tomography angiography（CTA） in the diagnosis of diabetic lower extremity artery diseases（DLEAD）.Methods Forty-five patients with clinically known type-Ⅱ diabetes associated with DLEAD underwent CTA examinations,of whom,31 patients underwent additional digital subtraction angiography（DSA） for comparing the diagnostic accuracy of CTA.The imaging findings of CTA in all patients were retrospectively analyzed and compared with that of DSA.Results CTA could clearly visualize the site and range of DLEAD,compared with DSA,the total corresponding rate in diagnosing DLEAD was 93.1%,while the corresponding rate in iliac-,femoral-and popliteal arteries was 100%,that in deep femoral arteries was 93.54%,that in anterior tibial arteries was 96.77%,that in posterior tibial arteries was 90.32%,and that in fibular arteries was 87.09%.The total corresponding rate between CTA and DSA was not statistical difference（P 0.05） but the corresponding rate in arteria dorsalis pedis was 77.42% and was statistic difference（P 0.05）.Conclusion CTA in diagnosing DLEAD has high accuracy,noninvasive and repeatable advantages,so that it should be the first choice replacing DSA.