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目的探讨CT血管造影(CTA)对严重下肢缺血(CLI)的诊断价值及其在介入治疗前的应用价值。方法前瞻性收集连续42例行介入治疗的CLI患者,其中男性28例,女性14例;年龄54~85岁,中位年龄68岁。所有患者在介入治疗前均行CTA检查,共有69个动脉节段接受介入治疗。利用Pearson相关系数定量分析CTA与数字减影血管造影(DSA)在诊断CLI患者狭窄病变程度及范围中的相关性;并分析CTA对动脉严重狭窄(>70%)及闭塞的诊断效能,并对CTA在介入治疗前的应用价值行定量化评分。结果 CTA与DSA对狭窄或闭塞病变程度及范围的测量有较好的一致性(r=0.98;P<0.01),CTA诊断严重狭窄及闭塞的敏感度为98.2%,特异度为98.9%,阳性预测值99.1%,阴性预测值98.6%。CTA在介入治疗前的应用价值定量化平均得分为2.87分。结论 CTA能够客观、准确地描述CLI患者的病变程度及范围,为介入治疗CLI提供有价值的信息。
Objective To investigate the value of CT angiography (CTA) in the diagnosis of severe lower limb ischemia (CLI) and its value before interventional therapy. Methods Forty-two consecutive CLI patients undergoing PCI were enrolled. Among them, 28 were male and 14 were female; mean age was 54 to 85 years and median age was 68 years. All patients underwent CTA before interventional therapy. A total of 69 arterial segments were treated with interventional therapy. Pearson correlation coefficient was used to quantitatively analyze the correlation between CTA and digital subtraction angiography (DSA) in diagnosing the degree and extent of stenosis in patients with CLI. The diagnostic efficacy of CTA on severe arterial stenosis (> 70%) and occlusion was analyzed. CTA in the interventional treatment before the value of quantitative determination of the line. Results There was a good agreement between CTA and DSA in measuring the extent and extent of stenosis or occlusion (r = 0.98; P <0.01). The sensitivity and specificity of CTA in diagnosing severe stenosis and occlusion were 98.2% and 98.9% The predicted value was 99.1% and the negative predictive value was 98.6%. The mean value of quantification of CTA before intervention was 2.87. Conclusions CTA can objectively and accurately describe the extent and extent of CLI lesions in CLI patients and provide valuable information for interventional treatment of CLI.