糖尿病足患者下肢血管MRA与CTA诊断对比研究

Comparison between MRA and CTA in 41 patients with diabetic feet

目的文章着重对糖尿病足下肢血管病变的MRA及CTA诊断效果进行对比研究。方法对41例临床确诊糖尿病足患者的下肢血管行MRA、CTA、DSA检查,以DSA为金标准,分析MRA、CTA对糖尿病足患者下肢血管病变的诊断效果。结果 MRA对于糖尿病足下肢血管病变成像的总体准确性、敏感性及特异性分别为97.8%、98%、97.7%,CTA对于糖尿病足下肢血管病变成像的总体准确性、敏感性及特异性分别为96.7%、94.9%、98.1%。膝上动脉组,MRA的成像准确性、敏感性、特异性为98.4%、98.4%、98.4%,CTA的准确性、敏感性、特异性分别为97.8%、98%、97.6%。膝下动脉组,MRA的准确性、敏感性、特异性分别为96.7%、97%、96.6%,CTA的准确性、敏感性、特异性分别为94.7%、83.3%、98.9%。结论 MRA及CTA均为诊断糖尿病足下肢血管病变有效的影像学方法,且MRA及CTA对于糖尿病足下肢血管病变的整体诊断效果无明显差异,但MRA对膝下动脉病变的诊断优于CTA。

Objective To evaluate the efficiency of CTA and MRA in the morphologic assessment of diabetic feet as compared to DSA. Methods 41 patients with clinically diagnosed diabetic feet underwent the CTA, MRA and DSA. The MRA and CTA were compared to DSA as the gold standard. Results Both MRA and CTA had high overall accuracy（97.8%, 96.7%）, specificity（97.7%, 98.1%）, and sensitivity（98.0%, 94.9%）. The accuracy, specificity and sensitivity for MRA and CTA in the superior genicular artery were 98.4% and 97.8%, 98.4% and 97.6%, 98.4% and 98.0%; in inferior genicular artery 96.6% and 94.7%,96.7% and 98.9%, 97.0% and 83.3%, respectively. Conclusion MRA and CTA have high agreement with DSA and have similar overall accuracy for the assessment of diabetic foot. MRA is more sensitive than CTA for the evaluation of inferior genicular artery.