糖尿病足下肢动脉CTA表现及重建方式的准确性评估(1)

http://www.100md.com 2010年1月1日 徐锐 张爱莉 李建龙 王瑞敏 赵龙华

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     【摘要】 目的 评估CTA对糖尿病足患者的应用价值,寻找最佳的显示方式,评估患者侧支循环情况。方法 选择符合糖尿病足诊断标准的患者45例行下肢动脉CTA检查。使用薄层横轴位图像、MIP、MPR、VRT评估成像血管状态;部分患者与DSA对照。结果 44例患者发现不同程度的下肢动脉病变;23例(59支)动脉血管闭塞后,周围有侧支循环建立。CTA对病变血管中度及以上狭窄程度的判断与DSA的符合率为97.43%,二者之间无显著差异(χ2=20.025,P=0.067);与DSA测量值最接近的是横轴位图像,VRT、MPR及MIP方式对轻度狭窄更不敏感,薄层MIP显示细小血管更清晰,VRT方式更容易将重度狭窄判读为闭塞。结论 CTA是评估糖尿病足患者经济、准确的方法;薄层横轴位图像、MIP是评估血管更有效;严重动脉病变患者侧支循环的建立与病变部位有关。

    【关键词】

    糖尿病;动脉硬化;CTA

    CTA findings in the lower extremity arterial disease of diabetic foot and the accuracy of reconstruction modes

    XU Rui,ZHANG Aili,LI Jianlong,et al.Medical Imaging Department of Rizhao People’s hospital,Rizhao 276800,China

    【Abstract】 Objective To evaluate the application of CTA in the lower extremity arterial disease of diabetic foot,to find the best display mode and evaluate the capability of collateral circulation formation.Methods 45 patients conforming to standard of diabetic foot were chosen as study subjects.Axial imagings,MIP,MPR and VRT techniques were used to evaluate the target vessels.Part of the patients were compared with DSA.Results Some kinds of artery lesions were found in 44 patiends.Collateral circulation was found in 23 patients(59 arterys with occlusion).Compared with DSA,the diagnostic accuracy of CTA was 97.43% in judging the degree of medium or more server stenosis,and no significant difference was found between the two techniques(χ2=20.025,P=0.067).Axial imagings had the most similar measure value compared with DSA.MIP,MPR and VRT techniques were insensitive to mild stenosis.MIP could show more minute blood vessels.Severe stenosis could be identified incorrectly as occlusion when VRT technique was used.Conclusion CTA might be the most economic and accurate method to evaluate the lower extremity arterial disease of diabetic foot;The most effective technique to evaluate the arteries was Axial imagings and MIP;The location of the severe artery lesions was the key point in collateral circulation formation.

    【Key words】

    Diabetic foot; Angiosclerosis;CTA

    DOI:10.3760/cma.j.issn 16738799.2010.01.10

    作者单位:276800日照市人民医院影像科 ......

    http://www.100md.com/html/paper/1673-8799/2010/01/10.htm

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