能谱CTA对胫骨横向骨搬移术后下肢动脉灌注效果的评价
Evaluation of the effect of lower extremity arterial perfusion after tibial transverse transport using spectral CTA
刘登平 1卢山1
作者信息
- 1. 天津医科大学朱宪彝纪念医院放射科 天津市内分泌研究所 国家卫健委激素与发育重点实验室 天津市代谢性疾病重点实验室 天津 300134
- 折叠
摘要
目的 探讨利用能谱CT血管造影(CT Angiography,CTA)评价糖尿病下肢动脉粥样硬化闭塞症患者胫骨横向骨搬移(Tibial Transverse Transport,TTT)术后下肢血流灌注的改善情况.方法 选取本院因糖尿病足伴下肢重度动脉粥样硬化闭塞症并行TTT手术的患者 27 例,术前及术后分别利用能谱模式进行下肢动脉CTA检查,两次检查间隔时间 4～6 个月.评价术后糖尿病足的预后情况,同时利用对比分析术前及术后下肢动脉管腔内CT值的变化情况及主观血管评分评价下肢动脉的灌注效果.结果 1)临床预后:27 例中 22 例预后良好,2 例预后不良,3 例足部创面愈合一般;2)管腔内CT值变化:术后管腔内CT值均不同程度升高,除胫后动脉管腔内手术前、后比较CT值差异无统计学意义(P>0.05)之外,其余部位差异均有统计学意义(P<0.05).主观血管评分:小腿胫前-足背动脉段图像评分差异有统计学意义(P<0.05),其余节段血管评分差异无统计意义(P>0.05).下肢动脉小腿段管腔内CT值变化幅度与糖尿病足溃疡预后之间的相关性良好(r=0.6,P=0.001),分析显示糖尿病足预后及Wagner分级显著正向预测小腿段血管内CT值变化情况.结论 能谱 CTA能够有效的评价下肢动脉粥样硬化闭塞症TTT术后血流改善情况,可以应用于术后效果的评价.
Abstract
Objective To evaluate the improvement of lower extremity blood perfusion after Tibial Transverse Transport(TTT)in patients with diabetic lower extremity atherosclerotic occlusive disease by spectrum CT angiography(CTA).Meth-ods 27 patients with diabetic foot complicated with severe atherosclerotic obliterans of the lower extremity undergoing TTT were selected in our hospital.CTA examination of the lower extremity artery was performed using the energy spectrum before and after surgery,and the interval of preoperative and postoperative examination was 4-6 months.We evaluated the prognosis of postopera-tive diabetic foot and the perfusion effect of lower limb artery by comparing and analyzing the changes of luminal CT value and subjective vascular score before and after operation.Results 1)Clinical prognosis was as follows:among the 27 patients,22 had a good prognosis,2 had a poor prognosis,and 3 had ordinary wound healing;2)With respect to the changes in intracavitary CT values,the intracavitary CT values increased to varying degrees after surgery,and there were statistically significant differ-ences in other sites except for the posterior tibial artery intracavitary CT values before and after surgery(P<0.05).As for the subjective vascular scores,there were significant differences in the image scores of the anterior tibial and dorsal foot artery seg-ments(P<0.05),but no significant differences in the other segments.There was a good correlation between the amplitude of changes in luminal CT values in the lower extremity artery segment and the prognosis of diabetic foot ulcer(r=0.6,P=0.001).Multiple linear regression analysis showed that the prognosis of the diabetic foot and Wagner scale significantly predicted the positive changes in the intravascular CT values in the lower extremity segment.Conclusion Spectrum CTA can effectively evaluate the improvement of blood flow after TTT in lower extremity atherosclerosis obliterans,which can be used to assess the postoperative effect.
关键词
动脉粥样硬化/糖尿病足/胫骨横向骨搬移/体层摄影术,X线计算机Key words
Atherosclerosis/Diabetic foot/Lateral displacement of tibia/Tomography,X-ray computer引用本文复制引用
出版年
2024
NETL
NSTL
万方数据