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目的评价多排螺旋CT血管造影(MSCTA)与数字减影血管造影(DSA)对2型糖尿病下肢血管病变诊断价值比较及其意义。方法对临床诊断为2型糖尿病下肢血管病变患者行双下肢MSCTA检查,对有严重下肢动脉狭窄或闭塞的38例患者行一侧或双侧下肢DSA检查,并同时行病变动脉的球囊扩张和(或)支架植入术;对比观察MSCTA与DSA检查的符合情况并计算MSCTA检查的敏感度、特异度及准确度。结果糖尿病双侧髂动脉Ⅲ、Ⅳ级病变MSCTA敏感度、特异度及准确度均为100%,MSCTA对股、腘动脉Ⅲ、Ⅳ级病变诊断均准确度分别为93.3%、93.8%,对膝下动脉Ⅲ、Ⅳ级病变诊断的准确度均为88.1%。结论MSCTA能准确直观地反映下肢血管的立体解剖特点,为糖尿病下肢血管病变的诊断与治疗提供重要依据,对介入治疗穿刺部位和方法的选择、干细胞移植术后和介入治疗术后患者的复查、随访,具有很高的实用价值。
Objective To evaluate the diagnostic value of multi-slice spiral CT angiography (MSCTA) and digital subtraction angiography (DSA) in the diagnosis of lower extremity vascular lesions in type 2 diabetes mellitus (T2DM). Methods MSCTA was performed on lower extremities in patients with clinically diagnosed type 2 diabetic lower extremity vascular lesions. One side or two lower extremities DSA were performed in 38 patients with severe lower extremity arterial stenosis or occlusion and simultaneous balloon dilatation (Or) stenting. The comparisons were made between the compliance of MSCTA with DSA and the sensitivity, specificity and accuracy of MSCTA. Results The sensitivity, specificity and accuracy of MSCTA in grade Ⅲ and Ⅳ diabetic bilateral iliac artery disease were all 100%. The accuracy of MSCTA in diagnosing type Ⅲ and Ⅳ grade of common iliac artery was 93.3% and 93.8% respectively. Arterial Ⅲ, Ⅳ grade diagnostic accuracy of the lesions were 88.1%. Conclusion MSCTA can accurately and intuitively reflect the anatomical characteristics of lower extremity blood vessels and provide an important basis for the diagnosis and treatment of diabetic lower extremity vascular lesions. The selection of the site and method of interventional treatment for puncture and the review of patients after interventional therapy and stem cell transplantation, Follow-up, with high practical value.