【摘要】 目的探讨不同造影剂在CT血管造影对下肢动脉硬化闭塞症患者的诊断价值。方法选取2013年1月至2015年10月首都医科大学附属北京潞河医院收治的临床疑似下肢动脉硬化闭塞症患者70例。同时采用碘海醇造影剂与碘普罗胺造影剂多层螺旋CT血管造影成像检测,以数字减影血管造影(DSA)作为金标准。检测后观察两组患者股深动脉和股浅动脉分叉处、胫前动脉和胫后动脉上段CT值、CT血管成像诊断效能各指标以及扫描长度、剂量长度乘积以及有效剂量值。结果检测后,患者股深动脉和股浅动脉分叉处、胫前动脉和胫后动脉上段CT值比较差异无统计学意义(P>0.05)。碘海醇造影剂的灵敏度98.18%、特异度86.67%、准确度95.71%、阳性预测值96.43%、阴性预测值92.86%均高于碘普罗胺造影剂87.27%、71.43%、84.06%、92.31%、58.82%;碘海醇组剂量长度乘积、有效剂量显著低于碘普罗胺组[(1005±113)m Gy·cm比(1179±117)m Gy·cm,(19.2±2.6)m Sv比(34.1±3.1)m Sv],差异有统计学意义(P<0.01)。结论碘海醇造影剂对下肢动脉硬化闭塞症诊断具有较高的临床应用价值,是检测和评估的有效手段,值得推广使用。更多还原

【Abstract】 Objective To investigate the diagnostic value of different contrast agents in CT angiography for patients with arteriosclerosis obliterans of lower extremities. Methods Total of 70 cases with suspected lower limb arteriosclerosis obliterans in Luhe Hospital Affiliated to Capital Medical University from Jan. 2013 to Oct. 2015 were included in the study. Iohexol contrast agent and iopromide contrast agent were used for multi-slice spiral CT angiography detection,with digital subtraction angiography( DSA) as the gold standard.After detection the deep and superficial femoral artery bifurcation,the anterior tibial artery and posterior tibial artery segment CT values,diagnostic performance of each CT angiography index and scan length,dose length product and effective dose values of the two groups were observed. Results After testing,the patients’ deep and superficial femoral artery bifurcation had no statistically significant differences( P > 0. 05); iohexol contrast agent: sensitivity 98. 18%,specificity 88. 67%,accuracy 95. 71%,positive predictive value 96. 43%,negative predictive value 92. 86%,which were higher than iopromide contrast agent’ s 87. 27%,71. 43%,84. 06%,92. 31%,58. 82% correspondingly; the dose-length product and of iohexol contrast agent were significantly lower than iopromide contrast agent [( 1005 ± 113) m Gy · cm vs( 1179 ± 117) m Gy · cm,the( 19. 2 ± 2. 6) m Sv vs( 34. 1 ± 3. 1) m Sv],thedifferences were statistically significant( P < 0. 01).Conclusion Iohexol has high clinical value for the diagnosis of arteriosclerosis obliterans of lower extremities,which is an effective means of testing and assessment,thus should be promoted.更多还原