摘要
目的 分析64层CT血管成像(64-CTA)与数字减影血管造影(DSA)在糖尿病患者下肢动脉硬化闭塞症中的影像学价值。方法 收集2019年5月~2021年5月在我院确诊为糖尿病下肢动脉下肢动脉闭塞症的200例患者的64-CTA及DSA的资料,所有患者均先行64-CTA检查,24 h后行DSA检查,两种检查间隔均不超过2周。以DSA为金标准,计算64-CTA诊断糖尿病下肢动脉硬化闭塞症的敏感度、特异性、准确度、阳性预测值、阴性预测值,并计算64-CTA三种处理方式诊断符合率。结果 200例患者中有64-CTA与DSA对照的共2265节段,以DSA为金标准,64-CTA发现有2115个节段与DSA一致,诊断符合率为93.38%。64-CTA高估1级共86节段,低估1级共53节段,绘制64-CTA与DSA显示下肢动脉狭窄分级节段分布曲线图,Kappa一致性检验结果显示Kappa值=0.915(P<0.01)。以DSA为金标准,64-CTA诊断糖尿病下肢动脉硬化闭塞症有狭窄的敏感度为97.27%、特异性为98.17%、准确度为97.62%、阳性预测值为98.83%、阴性预测值为95.76%,对各个诊断界点的诊断效能均较高。以DSA为金标准,64-CTA-MIP符合率为88.74%,64-CTA-MPR符合率为92.98%,64-CTA-VR符合率为88.74%,64-CTA-MIP、64-CTA-VR诊断符合率明显低于64-CTA(P<0.05)。病例图像分析发现64-CTA显示的狭窄程度较DSA更接近真实情况。结论64-CTA可准确显示糖尿病下肢动脉硬化闭塞症的狭窄程度,与DSA检查一致性较高,可作为该疾病的首要筛选检查方法。
Objective To analyze the imaging value of 64-slice CT angiography(64-CTA) and digital subtraction angiography(DSA) in lower limb arteriosclerosis obliterans in diabetic patients. Methods The data of 64-CTA and DSA of 200 patients with diabetic lower limb arterial occlusive disease diagnosed in our hospital from May 2019 to May 2021 were collected. All patients underwent 64-CTA examination, and DSA examination was performed after 24 h. The interval between the two examinations was not more than 2 weeks. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of64-CTA in the diagnosis of diabetic lower extremity arteriosclerosis obliterans were calculated using DSA as the gold standard.The diagnostic coincidence rates of the three treatment methods of 64-CTA were calculated. Results A total of 2265 segments of200 patients were compared between 64-CTA and DSA. Taking DSA as the gold standard, 2115 segments of 64-CTA were consistent with DSA, with a diagnostic coincidence rate of 93.38%. 64-CTA overestimated grade 1 by 86 times and underestimated grade 1 by 53 times. The distribution curve of 64-CTA and DSA showing the grade of lower limb arterial stenosis was drawn. The results of kappa agreement test showed that the kappa value=0.915(P<0.01). Taking DSA as the gold standard, 64-CTA had a sensitivity of 97.27%, specificity of 98.17%, accuracy of 97.62%, positive predictive value of 98.83% and negative predictive value of 95.76% for diagnosing diabetic lower extremity arteriosclerosis obliterans, with a high diagnostic efficacy for each diagnostic cut-off point. The coincidence rate of 64-CTA-MIP was 88.74%, the coincidence rate of 64-CTA-MPR was 92.98%, and the coincidence rate of 64-CTA-VR was 88.74%, and the diagnostic coincidence rate of 64-CTA-MIP and64-CTA-VR was significantly lower than that of 64-CTA(P<0.05). Image analysis showed that the degree of stenosis displayed by 64-CTA was closer to the true situation than that of DSA. Conclusion 64-CTA can accurately show the
作者
张文华
刘杰文
叶奕兰
郑伟
曾琳
ZHANG Wenhua;LIU Jiewen;YE Yilan;ZHENG Wei;ZENG Lin(Department of Medical Imaging,West Theater Air Force Hospital,Chengdu 610021,China)
出处
《分子影像学杂志》
2022年第2期256-260,共5页
Journal of Molecular Imaging
基金
四川省科技计划项目(2021YJ0143)。
