Objective:To investigate the diagnostic value of lower extremity CTA and foot CT perfusion in lower extremity arteriosclerotic obliterans(ASO)combined with foot ulcer.Methods:A total of 29 patients who were clinically diagnosed as ASO combined with foot ulcer in our hospital were collected to analyze the stenosis of lower limb artery,and to explore the sensitivity and specificity of lower extremity artery stenosis in pre-judging ulcer foot in ASO patients.The differences of perfu-sion values between ulcer and non-ulcer feet were analyzed,including blood flow(BF),blood volume(BV),surface permeability(PS),mean transit time(MTT)and time To max(Tmax).Receiver oper-ating characteristic curve(ROC)was used to analyze the degree of arterial stenosis of the lower ex-tremity and the value of perfusion values in the diagnosis of ulcerative foot.Results:A total of 30 ulcer-ated feet and 28 non-ulcerated feet were enrolled in the group.①Severe stenosis and occlusion of pos-terior tibial artery(PTA)(73.30％)and anterior tibial artery(ATA)(70.00％)were higher than those of the perinea artery(PA)(53.30％).②The severe stenosis/occlusion of superior knee arteries(superficial femoral and popliteal arteries)in ulcerated feet compared with that in non-ulcerated feet was statistically significant(P＜0.05).ROC curve results showed that the AUC value for ASO foot ulcer pre-judged by joint superior knee artery severe stenosis/occlusion was 0.78,the sensitivity was 76.7％,and the specificity was 67.9％.There was no significant statistical significance in the number and distribution of infrapopliteal arterys which cause severe stenosis/occlusion(P＞0.05).③Foot CT perfusion showed that the values of BF,BV,Tmax and PS in ulcerated feet were statistically different from those in non-ulcerated feet(P＜0.05).ROC curve results showed that the AUC value diagnosed by combining of BF,BV,Tmax and PS was 0.91,the sensitivity was 76.7％,and the specificity was 96.4％.Compared with the degree of arterial stenosis of the lower extremities,the diagnostic perform-ance was higher,and the difference was statistically significant(P＜0.05).④The AUC value of ASO foot ulcer diagnosed by superior knee artery stenosis combined with CT perfusion value was 0.93,sen-sitivity was 83.3％,specificity was 92.9％.Compared with the diagnostic performance of CT perfusion value,there was no statistically significant difference(P＞0.05).Conclusion:Lower extremity CT A combined with foot CT perfusion can assist in the diagnosis of lower extremity arteriosclerotic obliter-ans complicated with foot ulcers,providing valuable guidance for clinical treatment decisions.
维普
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