MSCTA对下肢动脉硬化闭塞症的诊断价值

目的探讨多层螺旋CT血管造影（MSCTA）对下肢动脉硬化闭塞症的临床应用价值。方法对41例下肢动脉硬化闭塞症患者，先后行下肢动脉MSCTA和数字减影血管造影（DSA）检查，两者检查间隔≤2周。gADSA为金标准，对比分析CTA与DSA在下肢动脉各节段动脉狭窄程度、狭窄或闭塞周围侧支上的显示能力。结果MSCTA与DSA在下肢动脉狭窄（≥50％）、狭窄或阻塞病变周围的代偿的侧支血管显示能力上无明显差异。MSCTA诊断下肢动脉狭窄（≥50％）的敏感度为97．2％，特异度为98．2％，阳性预测值为94．6％，阴性预测值为98．2％。结论MSCTA为诊断下肢动脉硬化闭塞症的可靠检查方法，能有效指导其治疗方案的制定。

Objective To explore the clinical value of multi-slice spiral CT angiography in lower extremity arteriosclerosis obliterans. Methods MSCTA and DSA of lower extremity arteries were performed in 41 patients with lower extremity arteriosclerosis obliterans sequentially. The interval of these two examinations was no more than 2 weeks. DSA served as the reference standard and compared with MSCTA in terms of grading of stenoocclusive lesions, visualization of collaterals in lower extremity arteries. Results No significant differences of grading of stenoocclusive lesions, visualization of collaterals were observed between MCTA and DSA of lower extremity arteries. Compared with the results of DSA, the sensitivity, specificity, positive and negative predictive value of MSCTA in the detection of arterial stenosis（〉50%）were 97.2%, 98.2%, 94.6%, 98.2%,respectively. Conclusion Multi-slice spiral CT angiography is a reliable method in diagnosing arteriosclerotic occlusive disease of lower extremities, which can effectively guide the development of their treatment plan.