CTA与多普勒超声检查在下肢动脉硬化闭塞症诊断中的对比分析
Comparative study of CT angiography and color doppler ultrasound in the diagnosis of lower extremity arteriosclerotic obstruction
段波 1高斌 1李伍好 1韦玉国1
作者信息
- 1. 安徽医科大学第三附属医院(合肥市第一人民医院)影像中心 安徽 合肥 230001
- 折叠
摘要
目的 探讨CT血管造影(CTA)与多普勒超声(DUS)检查在下肢动脉硬化性闭塞症(ASO)中的诊断效能.方法 选取我院经数字减影血管造影(DSA)检查并接受腔内血管成形术治疗的 80 例ASO患者.以DSA作为金标准,对比患者术前CTA及DUS诊断ASO的效能及一致性.结果 CTA对全段下肢动脉及髂动脉段≥50%血管狭窄及闭塞的检出率分别较DUS高 4.89%(P=0.002)和 2.29%(P=0.007).CTA对下肢全段≥50%血管狭窄及腘上动脉段管腔闭塞的诊断效能及一致性均高于DUS(敏感性:81.47%～96.84%vs 80.35%～89.66%;特异性 82.39%～90.75%vs 82.16%～87.25%;Kappa 值:0.82～0.98 vs 0.79～0.94),而对腘下动脉段血管闭塞的评估表现不及 DUS(敏感性:77.83%vs 78.49%;特异性:72.15%vs 79.28%;Kappa值:0.72 vs 0.76).结论 CTA对ASO患者的血管评估效能总体优于DUS,而对于腘下动脉段血管重度狭窄及闭塞仍需联合DUS综合评估,以制定最佳临床治疗方案.
Abstract
Objective This study aimed to evaluate and compare the diagnostic performance of computed tomography angiog-raphy(CTA)and duplex ultrasonography(DUS)in arteriosclerotic obstruction(ASO)of the lower limb arteries.Methods This retrospective study included 80 ASO patients who underwent digital subtraction angiography(DSA)and intravascular angio-plasty treatment at our hospital.The diagnostic performance and agreement of preoperative CTA and DUS in diagnosing ASO were compared using DSA as the gold standard.Results CTA had a higher detection rate than DUS for≥50%stenosis or occlu-sion in the entire lower limb arteries and the iliac artery segment with differences of 4.89%(p=0.002)and 2.29%(P=0.007),re-spectively.CTA showed higher diagnostic performance and agreement than DUS for≥50%stenosis in the entire lower limb and the above popliteal artery segments(sensitivity:81.47%～96.84%vs 80.35%～89.66%;specificity:82.39%～87.25%vs 82.16%～90.75%;Kappa value:0.82～0.98 vs 0.79～0.94).However,CTA was less effective than DUS in evaluating arterial occlusion in the below popliteal artery segments(sensitivity:77.83%vs 78.49%;specificity:72.15%vs 79.28%;Kappa value:0.72 vs 0.76).Conclusion CTA shows overall better vascular assessment performance than DUS in ASO patients,but a combined evaluation with DUS is still necessary for severe stenosis or occlusion in the below popliteal artery segment to determine the opti-mal clinical treatment strategy.
关键词
下肢动脉硬化性闭塞症/体层摄影术,X线计算机/血管造影/超声检查/数字减影血管造影Key words
Arteriosclerotic obstruction of the lower limb arteries/Tomography,X-ray computed/Angiography/Ultrasound examination/Digital subtraction angiography引用本文复制引用
出版年
2024
NETL
NSTL
万方数据