CT血管造影在下肢动脉硬化闭塞症诊断中的应用价值

Application of CT angiography in the diagnosis of lower extremity atherosclerosis obliterans

目的探讨CT血管造影(CTA)在下肢动脉硬化闭塞症(ASO)诊断中的应用价值。方法选择下肢ASO患者91例(患肢101条,动脉节段1 121个),分别行CTA及数字减影血管造影(DSA);每条下肢血管分为11个动脉节段;根据血管受累情况分为正常、轻度、中度、重度狭窄和闭塞。以DSA结果为标准,评估CTA的敏感性、特异性、诊断准确率。结果 1121个节段动脉中,502个狭窄闭塞节段动脉在DSA中得到诊断。与DSA比较,CTA在评估闭塞动脉节段的敏感性为96.9%、特异性为97.7%;Kappa=0.786,P<0.05;与DSA相比较,CTA对下肢动脉狭窄程度分级方面差异无统计学意义(Z=-0.933,P<0.05)。结论 CT血管造影是下肢ASO术前评估可靠、有效、无创的方法。

Objective To evaluate application value of CT angiography (CTA) in the diagnosis of lower extremityatherosclerosis obliterans (ASO). Methods 91 patients with lower extremity ASO underwent both CTA and digitalsubtraction angiography (DSA) were enrolled. Each lower extremity artery was divided into 11 segments. The arteries weredefined as normal, mild, moderate or severe stenosis or occlusion based on vessel lesions. The sensitivity, specificity anddiagnostic accuracy of CTA in evaluating vessel lesions were determined according to the results of DSA. Results A totalof 1121 segments were evaluated by both CTA and DSA. Arterial stenosis or occlusion was diagnosed by DSA in 502segments. The sensitivity and specificity of CTA for diagnosis of arterial occlusion were 96.9% and 97.7%, respectively(Kappa was 0.786, P<0.05). There was no significant difference between DSA and CTA in grading stenosis of lowerextremity arteries (Z value = 0.933, P<0.05). Conclusion CTA is a reliable, effective and noninvasive method for thepreoperative evaluation of lower extremity ASO.