3DCE-MRA对糖尿病患者下肢动脉硬化特征的研究

Characteristics study of 3DCE-MRA in diabetic patients with lower extremity arteriosclerosis

目的 :评价三维增强MRI血管造影(3DCE-MRA)对糖尿病(DM)患者下肢动脉硬化病变的诊断价值,并分析DM下肢动脉病变特点。方法:对47例DM(DM组)和39例非糖尿病(NDM)(NDM组)下肢动脉硬化患者行3DCE-MRA检查。以NDM组为对照,分析DM组下肢动脉病变特点。结果:DM组狭窄血管累及率为58.2%,NDM组狭窄血管累及率为42.6%,两者差异有统计学意义(P<0.05)。DM组以轻中度狭窄为主,闭塞血管(9.1%)发生率较NDM组(19.9%)低(P<0.05)。DM组血管狭窄主要分布在膝下中小动脉(56.5%),NDM组主要分布在膝上大血管(54.5%)。DM组膝下狭窄血管,腓动脉(15.2%)分别与腘动脉(27.2%)、胫前动脉(29.8%)、胫后动脉(27.8%)相比,差异均有统计学意义(均P<0.05)。结论 :3DCE-MRA能较准确显示DM下肢动脉病变;DM下肢动脉硬化发病率较NDM高;DM更易累及膝下中小动脉,以轻中度狭窄为主,且多累及腘动脉、胫前动脉、胫后动脉。

Objective：To evaluate the application of 3DCE-MRA in Diabetes Mellitus patients（DM group） with lower extremity arteriosclerosis disease. Analyze the characteristics of DM group lower extremity arterial disease. Methods：Give 47 case of DM group with the lower extremity arterial,and 39 case of NDM group with the lower extremity arterial 3DCE-MRA examination,compared the characteristics difference between DM group and NDM group. Results：58.2% DM group had stenosis,42.6%NDM group had stenosis,the difference was statistically significant（P〈 0.05）. DM group mainly had mild to moderate stenosis.The percentage of DM group with occlusion stenosis（9.1%） was lower than that of non-diabetic group（19.9%）（P〈 0.05）.DM group stenosis was mainly in small arteries below the knee（56.5%）,NDM group stenosis mainly in large vessels above the knee（54.5%）. DM group＇s stenosis involving rate below the knee,stenosis in peroneal artery was 15.2%,compared with the stenosis in popliteal artery（27.2%）,anterior tibial artery（29.8%） and posterior tibial artery（27.8%）,the difference was statistically significant（P〈 0.05）. Conclusions：3DCE-MRA can accurately display the lower extremity arterial disease of DM patients.Compared with the NDM group,the rate of DM group with lower limb arteriosclerosis is higher than the NDM group. DM is more likely to involve the small arteries below the knee with mild to moderate stenosis,such as the popliteal artery,anterior tibial artery.