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目的探讨三维对比剂增强磁共振血管造影(3DCE-MRA)在糖尿病足病(DF)下肢动脉病变检查中的应用价值,分析DF下肢动脉病变特点。方法对46例DF和39例非糖尿病单纯下肢动脉硬化(NDM)患者行CE-MRA检查,分析各动脉节段狭窄(≥50%)累计频度和狭窄积分,以NDM组为对照分析DF组动脉病变特点;以数字减影血管造影(DSA)为“金标准”分析CE-MRA的准确性。结果就动脉狭窄累及频度和积分而言,DF组远端动脉有高于近端的趋势,伴足部病变与不伴足部病变下肢之间无统计学差异;在膝以上动脉,DF组与NDM组无统计学差异;在膝以下动脉,DF组明显高于NDM组。CE-MRA诊断动脉狭窄(≥50%)的灵敏度、特异度及准确度分别为97.85%,84.85%,94.44%。结论 3DCE-MRA能较准确显示DF患者下肢动脉病变;与NDM相比,DF更易累及膝以下动脉,且下肢动脉病变与足部病变并不完全一致。
Objective To investigate the value of three-dimensional contrast-enhanced magnetic resonance angiography (3DCE-MRA) in the examination of lower extremity arterial disease in diabetic foot disease (DF) and analyze the characteristics of arterial lesions in lower extremity DF. Methods 46 cases of DF and 39 cases of non-diabetic simple lower extremity arteriosclerosis (NDM) patients underwent CE-MRA examination, analysis of the cumulative frequency and stenosis of each artery segment stenosis (≥ 50%), the NDM group as a control group DF Arterial lesion characteristics; CE-MRA accuracy by digital subtraction angiography (DSA) as the “gold standard”. Results For the frequency and integral of arterial stenosis, there was a tendency that the distal artery in DF group had a higher tendency than the proximal one. There was no significant difference between the foot lesions and the lower limbs without foot lesions. Compared with NDM group, there was no significant difference. In the artery below the knee, the DF group was significantly higher than the NDM group. The sensitivity, specificity and accuracy of CE-MRA in diagnosing arterial stenosis (≥50%) were 97.85%, 84.85% and 94.44% respectively. Conclusions 3DCE-MRA can accurately show the lower extremity arterial disease in patients with DF. Compared with NDM, DF is more likely to involve in the arteries below the knee, and the arterial lesions in the lower extremities are not completely consistent with the foot lesions.