64层螺旋计算机断层扫描血管造影与数字减影血管造影在下肢动脉病变诊断中的应用价值对比

Comparison on the application value of 64-slice spiral computed tomography angiography with digital subtraction angiography in the diagnosis of lower extremity arterial disease

目的对比64层螺旋计算机断层扫描血管造影(CTA)与数字减影血管造影(DSA)在下肢动脉病变诊断中的应用价值。方法回顾性分析本院62例下肢动脉病变患者,均先行CTA再行DSA,比较2种方法显示的下肢动脉狭窄分级情况,并以DSA为标准,计算CTA诊断下肢动脉狭窄的灵敏度、特异度、准确度、阳性及阴性预测值。结果 CTA与DSA结果符合率为91.20%。以DSA为标准,CTA检查共低估12段,高估26段。CTA诊断下肢动脉狭窄程度≥50%的灵敏度、特异度、准确度、阳性及阴性预测值分别为98.21%、96.15%、97.22%、96.49%及98.04%。结论 CTA在下肢动脉病变的诊断中具有较高的灵敏度、特异度、准确度、阳性及阴性预测值,且无创、方便、安全,可作为该病术前检查、评估以及随访的有效方法之一,并在一定程度上可取代DSA。

Objective To compare the application value of 64 - slice spiral computed tomography angiography （CTA） with digital subtraction angiography （DSA） in the diagnosis of lower extremity arterial disease. Methods Sixty- two patients with lower extremity arterial disease in our hospital were retrospectively analyzed, and they took CTA and DSA successively. The grading conditions of lower extremity arteriostenosis indicated by both methods were compared, and the sensitivity, specificity, accuracy as well as positive and negative values of lower extremity arteriostenosis diagnosed by CTA were calculated with DSA as a standard. Results The coincidence rate of CTA and DSA results was 91.2%. With DSA as a standard, 12 segments were underestimated and 26 segments were overestimated under CTA examination. The sensitivity, specificity, accuracy as well as positive and negative values of lower extremity arteriostenosis more than 50 % under CTA were 98.21%, 96.15 %, 97.22 %, 96.49 % and 98.04 %, respectively. Conclusion In the diagnosis of lower extremity arterial disease, 64 - slice spiral CTA has higher sensitivity, specificity, accuracy as well as positive and negative values. In addition, it is noninvasive, convenient and safe, can be one of the effective methods to exam, estimate and follow up this disease before operation and replace DSA to a certain extent.