CAJ | 학술논문

目的评价低浓度碘克沙醇在CT血管成像(CTA)诊断下肢动脉硬化闭塞症(LEASO)中的临床应用价值.方法收集2012年5月至2013年11月东南大学医学院附属盐城医院临床怀疑LEASO患者42例,随机分为A组(270 mgI/ml碘克沙醇、管电压100kV)和B组(320 mgI/ml碘克沙醇、管电压120 kV),每组21例.行下肢CTA检查之前,测定身高、体质指数(BMI).CTA结果以数字减影血管造影(DSA)检查为“金标准”进行对比分析.结果 A、B两组患者的年龄、性别、BMI及股深、浅动脉分叉处、胫前动脉和胫后动脉上段CT值差异均无统计学意义.对于闭塞,A、B两组CTA诊断的敏感性、特异性分别为97.0％,99.1％和98.3％,99.5％.以管腔达中度以上(含中度)狭窄的动脉为总体进行统计,A、B两组CTA诊断的敏感性、特异性分别为99.2％,99.3％和99.1％,99.3％;准确率分别为92.9％和93.0％;阳性预测值和阴性预测值分别为96.9％,99.3％和96.6％,99.3％.A、B两组CTA与DSA一致性检验kappa值分别为0.930和0.927,结果一致性较好.结论低浓度碘克沙醇结合低管电压CTA能够达到常规扫描的优越显影特性,在LEASO诊断中的具有较高的临床价值,是其检查、评估和随访的有效手段.
목적 평개저농도전극사순재CT혈관성상(CTA)진단하지동맥경화폐새증(LEASO)중적림상응용개치.방법 수집2012년5월지2013년11월동남대학의학원부속염성의원림상부의LEASO환자42례,수궤분위A조(270 mgI/ml전극사순、관전압100kV)화B조(320 mgI/ml전극사순、관전압120 kV),매조21례.행하지CTA검사지전,측정신고、체질지수(BMI).CTA결과이수자감영혈관조영(DSA)검사위“금표준”진행대비분석.결과 A、B량조환자적년령、성별、BMI급고심、천동맥분차처、경전동맥화경후동맥상단CT치차이균무통계학의의.대우폐새,A、B량조CTA진단적민감성、특이성분별위97.0％,99.1％화98.3％,99.5％.이관강체중도이상(함중도)협착적동맥위총체진행통계,A、B량조CTA진단적민감성、특이성분별위99.2％,99.3％화99.1％,99.3％;준학솔분별위92.9％화93.0％;양성예측치화음성예측치분별위96.9％,99.3％화96.6％,99.3％.A、B량조CTA여DSA일치성검험kappa치분별위0.930화0.927,결과일치성교호.결론 저농도전극사순결합저관전압CTA능구체도상규소묘적우월현영특성,재LEASO진단중적구유교고적림상개치,시기검사、평고화수방적유효수단.
Objective To evaluate the clinical diagnostic value of low concentration of iodixanol used in CT angiography (CTA) of lower extremity arteriosclerosis obliterans (LEASO).Methods 42 patients which were suspect diagnosed with LEASO were divided to A group (270 mgI/ml iodixanol,tube voltage 100 kV) and B group (350 mgI/ml iohexol,tube voltage 120 kV),21 patients in each group.Measure the body mass index (BMI) before the CTA of lower extremity.CTA results were analyzed with the digital subtraction angiography (DSA) as the "gold standard".Results There were no statistical difference of age,gender,BMI and CT value of the bifurcation of profunda femoral artery and superficial femoral artery,upper segment of anterior tibial artery and posterior tibial artery between A and B group.The diagnostic sensitivity and specificity of A and B groups of CTA were 97.0％,99.1％ and 98.3％,99.5％ for occlusion.Regard artery more than moderate stenosis (include moderate stenosis) as the overall statistics,the diagnostic sensitivity and specificity of A and B groups of CTA were 99.2％,99.3％ and 99.1％,99.3％,the accuracy were 92.9％ and 93.0％,the positive predictive and negative predictive value were 96.9％,99.3％ and 96.6％,99.3％,respectively.The kappa value of A and B groups of CTA and DSA consistency test were 0.930 and 0.927,respectively.Conclusion The CTA with low concentration of iodixanol combine with low tube voltage can achieve superior conventional scanning imaging features,and has great clinical value in the diagnosis of LEASO,also is an effective method for the inspection,evaluation and follow-up.