多普勒超声联合CT血管造影在糖尿病下肢血管病变诊断中的价值研究

目的探讨多普勒超声联合CT血管造影(CTA)在糖尿病下肢血管病变(LEAD)诊断中的价值。方法回顾性分析我院接诊的103例LEAD患者的临床资料,以X线数字减影血管造影(DSA)检查结果为诊断依据,均行多普勒超声和CTA检查,分析多普勒超声联合CTA诊断LEAD的准确性。结果 103例LEAD患者共检测1648段血管,DSA检出狭窄血管610段(37.01%),CTA检出狭窄血管600段(36.41%),多普勒超声检出狭窄血管535段(32.46%);DSA与CTA狭窄血管检出率比较,差异无统计学意义(χ^2=0.13,P>0.05);DSA狭窄血管检出率显著高于多普勒超声(χ^2=7.53,P<0.05);下肢动脉各节段多普勒超声联合CTA诊断与DSA比较,符合的1566段,准确率为95.02%,高估狭窄程度31段,低估狭窄程度51段,kappa值=0.901。结论多普勒超声联合CTA有助于提高诊断LEAD的准确性,联合成像与DSA的一致性较好。

Value of Doppler Ultrasound Combined with CT Angiography in the Diagnosis of Diabetic Lower Extremity Arterial Disease

Objective To explore the value of Doppler ultrasound combined with CT angiography(CTA) in the diagnosis of diabetic lower extremity arterial disease(LEAD). Methods The clinical data of 103 LEAD patients admitted to our hospital were analyzed retrospectively. The results of X-ray digital subtraction angiography(DSA) were taken as diagnosis standard, and patients were given Doppler ultrasound and CTA, and the accuracy of Doppler ultrasound combined with CTA was analyzed in diagnosing LEAD. Results A total of 1648 segments of blood vessels were detected in 103 LEAD patients, including 610 segments(37.01%) of stenosis vessels detected by DSA, 600 segments(36.41%) detected by CTA and 535 segments(32.46%) detected by Doppler ultrasound. There was no statistically significant difference in the detection rate of stenosis vessels by DSA or CTA(χ^2=0.13, P>0.05). The detection rate of stenosis vessels by DSA was significantly higher than that of Doppler ultrasound(χ^2=7.53, P<0.05). The comparison of lower extremity artery segments by Doppler ultrasound combined with CTA or DSA showed that 1566 segments were coincident with the accuracy rate of 95.02%, and there were 31 segments with overestimation of vessel stenosis and 51 segments with underestimation of vessel stenosis, and kappa value=0.901. Conclusion Doppler ultrasound combined with CTA helps to improve the accuracy in the diagnosis of LEAD, and has good consistency with DSA.