64层螺旋CT对周围血管性疾病的诊断价值:与DSA的对照研究

目的 通过与DSA比较评估64层螺旋CT血管成像诊断周围血管性疾病(peripheral vascular disease,PVD)的准确性及特异性.方法 30例PVD患者同时接受DSA及CT血管造影检查.血管狭窄程度分为5级:Ⅰ正常(无狭窄);Ⅱ轻度狭窄(1%～49%狭窄);Ⅲ中度狭窄(50%～74%狭窄);Ⅳ重度狭窄(75%～99%);Ⅴ闭塞.以DSA结果为金标准,分析64层螺旋CT的灵敏度、特异度等指标.结果 30例患者中,共有720支血管均有DSA及CTA成像.进行分析比较后发现,64层螺旋CT诊断下肢动脉有意义狭窄的灵敏度98.5%、特异度99.2%、阳性预测值99.1%、阴性预测值98.7%.结论 64层螺旋CT血管成像是诊断周围血管狭窄程度的一种准确、安全、无创的影像学诊断技术.

The diagnostic value of 64-multislice CT in patients with peripheral arterial occlusive diseases:comparison with digital subtraction angiography

Objective To compare CT angiography with 64-slice CT and digital subtraction angiography(DSA) in the diagnostic accuracy and specificity of peripheral vascular diseases.Methods Thirty patients with peripheral vascular diseases were referred for selective digital subtraction angiography(DSA)and also undergone CT angiography.Findings were graded according to 5 categories:1,normal(0% stenosis);2,mild(1%-49% stenosis);3,moderate(50%-74% stenosis);4,severe(75%-99% stenosis);5,occluded.CT angiography findings were compared with those of DSA for every equivalent arterial segment;taking the outcomes of DSA as gold standard and analizing the sensitivity and specificity etc.Results In all 30 patients,720 vessel segments were evaluated with both imaging modalities.Comparing with DSA,the sensitivity of CTA to diagnose significant stenosis was 98.5% and specificity 99.2%;with positive predictive value(PPV) of 99.1% and negative predictive value(NPV) of 98.7%.Conclusion 64-slice spiral CT angiography is an accurate,safe,noninvasive technique for diagnosing peripheral vascular stenotic diseases.