论文部分内容阅读
目的分析糖尿病足(DF)下肢动脉病变的CT血管造影(CTA)、磁共振血管造影(MRA)影像学特点及危险因素。方法以本院2014年3月-2016年3月确诊的57例糖尿病足下肢动脉病变患者为研究对象,均接受血管数字减影(DSA)、CTA、MRA检查,以DSA为金标准,比较CTA、MRA诊断敏感度、特异度及准确度;同时选择同期确诊的50例DF非下肢动脉病变患者为对照组,单因素及Logistic多因素回归分析DF下肢动脉病变危险因素。结果 CTA对膝下动脉、总体诊断敏感度分别为64.13%、90.78%,准确度分别为88.89%、94.72%,均显著低于MRA的98.91%、98.39%,97.66%、98.05%,差异有统计学意义(P<0.05);CTA、MRA对膝上动脉诊断敏感度、特异度、准确度比较均无显著差异(P>0.05);Logistic多因素回归分析显示DF下肢动脉病变独立危险因素包括高血压、体重指数(BMI)、餐后2h血糖(2h PG)。结论 CTA、MRA对DF下肢动脉病变诊断均有一定的价值,但MRA对下膝动脉病变诊断敏感度、准确度显著高,同时需对患者血压、血糖等指标监测,以了解DF发生、发展情况。
Objective To analyze CT angiography (CTA), magnetic resonance angiography (MRA) imaging features and risk factors of lower extremity artery disease in diabetic foot (DF). Methods Fifty-seven patients with diabetic lower extremity arterial disease diagnosed from March 2014 to March 2016 in our hospital were enrolled in this study. All patients underwent digital subtraction (DSA), CTA and MRA. DSA was taken as the gold standard. CTA , MRA diagnostic sensitivity, specificity and accuracy; at the same time select the same period confirmed 50 cases of DF non-lower extremity arterial disease patients as control group, single factor and Logistic regression analysis of DF lower extremity arterial disease risk factors. Results The sensitivity of CTA to the diagnosis of the inferior arteries was 64.13% and 90.78%, respectively, with the accuracy of 88.89% and 94.72%, respectively, which were significantly lower than those of MRA (98.91%, 98.39%, 97.66% and 98.05%, respectively) (P <0.05). The sensitivity, specificity and accuracy of CTA and MRA for the diagnosis of knee artery were not significantly different (P> 0.05). Logistic regression analysis showed that independent risk factors for arterial disease of DF lower extremity included hypertension , Body mass index (BMI), 2h postprandial blood glucose (2h PG). Conclusion CTA and MRA have some value in the diagnosis of arterial disease of lower extremity in DF. However, the sensitivity and accuracy of MRA in diagnosing arterial disease of knee are remarkably high. At the same time, the indexes of blood pressure and blood glucose should be monitored to understand the occurrence and development of DF .