多层螺旋CT血管成像技术在下肢动脉硬化闭塞症诊断中的应用研究

The Application Research on Multislice Spiral CT Angiography in the Diagnosis of Arteriosclerosis Obliterans of Lower Extremities

目的分析多层螺旋CT血管成像(MSCTA)在下肢动脉硬化闭塞症(PAOD)中的诊断效果,通过临床病例对比分析MSCTA与下肢动脉数字减影血管造影(DSA)在诊断PAOD上的一致性。方法选择2019年1月至2020年11月本院收录的86例下肢动脉硬化闭塞症患者MSCTA与DSA检查图像进行影像学诊断,并对诊断结果做统计学分析,以DSA诊断结果作为金标准分8节段计算MSCTA诊断敏感度、特异度与准确率,同时对阳性、阴性诊断预测做差异性比较。结果86例患者的MSCTA与DSA检查下肢动脉各688个节段图像中,MSCTA诊断结果中共663个节段与DSA结果一致,一致率为96.37%,一致性检验中Kappa值为0.974;MSCTA对比DSA诊断结果差异性比较中,敏感度、特异度与准确率,阳性、阴性预测值均大于90%。结论在诊断PAOD时,MSCTA能够有效的检查、评估下肢动脉硬化闭塞症动脉狭窄情况,可为后续治疗方案提供参考依据。

Objective To analyze the diagnostic effect of multi-slice spiral CT angiography(MSCTA)in lower extremity arteriosclerosis obliterans(PAOD),and to compare the consistency of MSCTA and digital subtraction angiography(DSA)in the diagnosis of PAOD.Methods 86 patients with arteriosclerosis obliterans of lower extremities from January 2019 to November 2020 were selected for imaging diagnosis by MSCTA and DSA,and the diagnostic results were statistically analyzed.The sensitivity,specificity and accuracy of MSCTA diagnosis were calculated by 8 segments with DSA diagnostic results as the gold standard,and the differences between positive and negative diagnostic predictions were compared.Results Among the 688 segments of lower extremity arteries examined by MSCTA and DSA,663 segments were consistent with DSA,the consistency rate was 96.37%,and the kappa value was 0.974;in the comparison of MSCTA and DSA,the sensitivity,specificity,accuracy,positive and negative predictive values were more than 90%.Conclusion In the diagnosis of PAOD,MSCTA can effectively check and evaluate the arterial stenosis of lower extremity arteriosclerosis obliterans,which can provide reference for the follow-up treatment.