多层螺旋CT血管造影评估糖尿病患者胰腺供血动脉的应用价值

Multi-Slice Spiral Computed Tomography Angiography of the Feeding Arteries of Pancreas: Comparison with Digital Subtraction Angiography

目的探讨多层螺旋CT血管造影(MSCTA)对糖尿病患者胰腺供血动脉的显示价值。方法回顾性研究103例糖尿病患者,均接受腹部64层螺旋CTA及腹部DSA检查,分别观察胰十二指肠动脉前弓、后弓、胰背动脉、胰大动脉的显示情况。应用配对χ~2检验或二项分布χ~2检验比较两种方法胰腺供血动脉的显示率;用配对秩和检验比较两种方法的胰腺供血动脉显示状况。结果 MSCTA与DSA对糖尿病患者胰十二指肠动脉前弓的显示率均为98.1%,对胰十二指肠动脉后弓显示率分别为96.1%、98.1%,两种方法对胰十二指肠动脉前弓、后弓的显示率无差异(P值分别为1.000、0.625,P>0.05);两种方法对胰十二指肠动脉前弓第一组、后弓第一组显示率均无差异(P值分别为1.000、0.250,P>0.05)。MSCTA和DSA对胰背动脉的显示率分别是64.1%、57.3%;对胰大动脉的显示率分别是77.7%、68.0%,两种方法对胰背动脉、胰大动脉显示率无差异(χ~2值分别为0.973、2.132,P值分别为0.324、0.144,P>0.05);两种方法对胰背动脉第一组、胰大动脉第一组显示率无差异(χ~2值为0.148、1.361,P=0.700、0.243)。两种方法对胰十二指肠动脉前弓及前弓第一组、后弓及后弓第一组、胰背动脉第一组、第二组显示状况评分存在差异,P值分别为0.000、0.000、0.000、0.000、0.003、0.037。两种方法对胰十二指肠动脉前弓第二组、三组,胰十二指肠动脉后弓第二、三组,胰背动脉及胰背动脉第三组,胰大动脉及其第一、二组显示状况评分无统计学差异。结论 MSCTA是评价胰腺供血动脉有效且可靠的检查方法。

Objective To investigate the clinical value of pancreatic artery in patients with diabetes by multi-slice spiral CT angiography. Methods 64-slice CT Angiography in abdomen and abdominal DSA were performed in 103 cases of diabetes mellitus meeting the inclusion and exclusion criteria. Two CTA radiologist and Two DSA radiologist retrospectively respectively evaluated and recorded the frequency and the degree of visualization of anterior pancreatic duodenal arcade（ APDA）,posterior pancreatic duodenal arcade（ PPDA）,dorsal pancreatic artery（ DPA）,pancreatic magna artery（ PMA）. Results In abdominal CTA and DSA,display rate of APDA were 98. 1% and 98. 1%,respectively; PPDA,96. 1%,98. 1%; DPA,64. 1%,57. 3%; PMA,77. 7%,68%. There was no difference in display rates of APDA,PPDA,DPA and PMA between CTA and DSA. So did the first group of APDA,DDPA,PMA,and DPA. The degree of visualization of APDA,the first group of APDA,PPDA,the first group of PPDA,the first and second group of DPA by DSA was better than that of CTA. There was no difference in the degree of visualization of the second and third group of APDA and PPDA,DPA,the third group of DPA,PMA and the first and the second group of PMA. Conclusion The multi-slice spiral CT angiography is effective and reliable method which can accurately detect artery of pancreas.