糖尿病下肢动脉病变64排螺旋CT血管成像分析

Analysis of 64 row spiral CT angiography in diabetic lower extremity arterial disease

目的:研究糖尿病下肢动脉病变64排螺旋CT血管成像(CTA)特征。方法:回顾性分析80例临床诊断为糖尿病,并行64排螺旋CTA检查的患者资料。下肢动脉分为4段(髂动脉段、股动脉段、腘动脉段和小腿动脉段)。统计下肢动脉病变部位、数目、性质、长度(<5cm,5~10cm和>10cm)并分析其特点。结果:根据4分段法,80例患者中病变动脉148条,多节段病变55(37.16%)条,其中受累股动脉104(70.27%)条,受累的小腿动脉134(90.54%)条。总病变325处,其中闭塞性疾病179(55.08%)处,狭窄性病变约146(44.92%)处。>10cm闭塞病变主要发生在小腿动脉66处,占小腿动脉病变的49.25%,以胫前动脉和胫后动脉为主。结论:糖尿病下肢动脉病变CTA表现主要以多节段硬化闭塞为主,多累及股动脉和小腿动脉。无创性CTA可用于下肢动脉病变的常规评估。

Objective To study the characteristics of 64 row spiral CT angiography(CTA)in diabetic lower extremity arterial disease(LEAD).Methods Analyze the clinical data of 80 diabetic cases that performed 64 row spiral CTA examination retrospectively.The arteries of lower extremity were divided into the following four segments:iliac,femoral,popliteal and crural artery.Count on the lower extremity arterial lesions,number,feature and length( < 5 cm,5~10 cm, >10 cm),and analyze the characteristic of LEAD.Results Of 148 diabetic lower limbs in the 80 cases,multiple segmental lesions were seen in 55(37.16%),femoral arterial lesions in 104,and crural arterial lesions in 134.Based on segmental angiographic classification,a total of 325 vascular lesions were detected,including stricture lesions(44.92%)and occlusive lesions(55.08%).Of the 134 crural lesions,70.90%were occlusions,and most of which were longer than 10 cm and located in anterior and posterior tibial arteries,while only a few peroneal arteries were involved(P < 0.05).Conclusion The main feature of diabetic LEAD is multi-level atherosclerotic occlusion,the femoral and the crural arteries are most likely to be involved.Noninvasive MSCTA can be used for routine evaluation of LEAD.