CTA在诊断下肢动脉硬化闭塞症中的应用价值

doi:10.3969/j.issn.1674-1633.2015.10.017

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摘要目的探讨CT血管造影（CTA）在诊断下肢动脉硬化闭塞症中的应用价值。方法回顾性分析57例经数字减影血管造影（DSA）确诊的下肢动脉硬化闭塞症患者的CTA检查资料。观察其狭窄程度，以DSA为金标准，计算CTA检查的敏感度、特异度、符合率、阴性预测值和阳性预测值。结果在狭窄程度的判断上，主髂动脉及股腘动脉的CTA与DSA具有极高的一致性。CTA诊断主髂动脉狭窄的敏感度、特异度、符合率、阴性预测值和阳性预测值分别为98.2%、95.3%、96.5%、98.8%、93.4%。CTA诊断股腘动脉狭窄的敏感度、特异度、符合率、阴性预测值和阳性预测值分别为96.8%、90.9%、95.2%、90.9%、96.8%。小腿动脉的CTA与DSA具有较高的一致性，一致性低于主髂动脉及股腘动脉，其敏感度、特异度、符合率、阴性预测值和阳性预测值分别为97.0%、87.2%、93.7%、93.8%、93.6%。结论 CTA是一种安全、可靠、无创的检查手段，能够准确地显示下肢动脉硬化狭窄的程度，并且与DSA检查具有较高的一致性，对下肢动脉硬化闭塞症具有较高的诊断价值。

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	郭静丽
	高伟
	刘浩

关键词 ：下肢动脉硬化闭塞症, CT血管造影, 数字减影血管造影

Abstract：Objective To investigate the effectiveness of application of CTA (Computerized Tomography Angiography) in diagnosis of lower extremity arteriosclerosis obliterans. Methods CTA imaging data of fifty-seven lower extremity arteriosclerosis obliterans patients who had been confirmed by DSA (Digital Subtraction Angiography) were analyzed retrospectively. Taking DSA as the standard, the degree of stenosis was observed and the sensitivity, specificity, coincidence rate, negative predictive value and positive predictive value detected by CTA were calculated. Results As for the degree of stenosis, the consistency of CTA and DSA in the aorto-iliac artery and femoropopliteal artery was almost perfect. The sensitivity, specificity, coincidence rate, negative predictive value and positive predictive value of CTA in diagnosis of aorto-iliac artery were 98.2%, 95.3%, 96.5%, 98.8% and 93.4% respectively, and which of femoropopliteal artery were 96.8%, 90.9%, 95.2%, 90.9% and 96.8% respectively. The consistency of CTA and DSA in diagnosis of crual artery was substantial, which was lower than aorto-iliac and femoropopliteal artery. The sensitivity, specificity, coincidence rate, negative predictive value and positive predictive value were 97.0%, 87.2%, 93.7%, 93.8% and 93.6% respectively. Conclusion CTA was a safe, reliable and noninvasive means. It could display the degree of stenosis of lower extremity arterial occlusive diseases accurately. And it had very high consistency with DSA in the diagnosis of lower extremity arterial occlusive diseases.

Key words： lower extremity arteriosclerosis obliterans computerized tomography angiography digital subtraction angiography

收稿日期: 2015-04-03

:	R543.5
	R814.42

通讯作者: 高伟 E-mail: gao1974@yeah.net

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引用本文:

郭静丽，高伟，刘浩. CTA在诊断下肢动脉硬化闭塞症中的应用价值[J]. 中国医疗设备, 2015, 30(10): 63-66.
GUO Jing-li, GAO Wei, LIU Hao. Effectiveness of Application of CT Angiography in Diagnosis of Lower Extremity Arteriosclerosis Obliterans. China Medical Devices, 2015, 30(10): 63-66.

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http://cs.china-cmd.org/zgylsb/CN/10.3969/j.issn.1674-1633.2015.10.017 或 http://cs.china-cmd.org/zgylsb/CN/Y2015/V30/I10/63

[1]	Ota H,Takase K,Igarashi K,et al.MDCT compared with digital subtraction angiography for assessment of lower extremity arterial occlusive disease:importance of reviewing cross-sectional images[J].AJR Am J Roentgenol,2004,182(1):201-219.
[2]	陈岩,季立平,石士奎,等.16层螺旋CT血管成像对下肢动脉闭塞性疾病的诊断价值[J].海南医学,2007,18(6):20.
[3]	隋守光,张伟,孙鹏.下肢动脉硬化闭塞症血管腔内治疗研究进展[J].当代医学,2009,(23):503-504.
[3]	隋守光,张伟,孙鹏.下肢动脉硬化闭塞症血管腔内治疗研究进展[J].当代医学,2009,(23):503-504.
[2]	陈岩,季立平,石士奎,等.16层螺旋CT血管成像对下肢动脉闭塞性疾病的诊断价值[J].海南医学,2007,18(6):20.
[2]	陈岩,季立平,石士奎,等.16层螺旋CT血管成像对下肢动脉闭塞性疾病的诊断价值[J].海南医学,2007,18(6):20.
[1]	Ota H,Takase K,Igarashi K,et al.MDCT compared with digital subtraction angiography for assessment of lower extremity arterial occlusive disease:importance of reviewing cross-sectional images[J].AJR Am J Roentgenol,2004,182(1):201-219.
[3]	隋守光,张伟,孙鹏.下肢动脉硬化闭塞症血管腔内治疗研究进展[J].当代医学,2009,(23):503-504.
[1]	Ota H,Takase K,Igarashi K,et al.MDCT compared with digital subtraction angiography for assessment of lower extremity arterial occlusive disease:importance of reviewing cross-sectional images[J].AJR Am J Roentgenol,2004,182(1):201-219.