增强MR血管成像在糖尿病下肢动脉狭窄中应用.docVIP

增强MR血管成像在糖尿病下肢动脉狭窄中应用 　　[摘要] 目的 探讨增强MR血管成像在糖尿病下肢动脉狭窄诊断中的准确性。方法 选择该院收治的糖尿病下肢动脉狭窄患者32例，先对所有患者的自第3腰椎体平面至脚尖进行增强MR血管成像检查，10d后再进行数字减影血管造影检查。结果 32例患者共324段血管均成像成功。以数字减影血管造影结果为准，增强MR成像的准确率为96.91%（314/324），敏感性为95.76%，特异性为97.57%;共6段血管被高估，4段血管被低估。两组检查结果一致性检验K=0.9546，具有高度一致性。 结论 增强MR血管成像可作为糖尿病下肢动脉狭窄筛查的可靠影像学检查方法。 　　[关键词] 增强MR;血管成像;糖尿病;下肢动脉狭窄;数字减影血管造影 　　[中图分类号] R47 [文献标识码] A [文章编号] 1672-4062（2016）01（a）-0108-02 　　Application of Enhanced MR Angiography in Lower Extremity Arterial Stenosis in Patients with Diabetes Mellitus 　　WU Zuoli 　　（The Department of Radiology， Daqing City Fourth Hospital， Daqing，Heilongjiang Province，163712 China 　　[Abstract] Objective To investigate the diagnostic accuracy of MR angiography in the diagnosis of lower extremity arterial stenosis. Methods 32 patients with diabetic lower extremity arterial stenosis were selected， and all patients were treated with the third lumbar vertebral body level to toe to enhance the MR angiography， and then the 10d was performed by digital subtraction angiography. Results In 32 patients， a total of 324 vessels successfully imaged. The accuracy of MR imaging was 96.91%， 95.76%， 97.57%， 6 segments of blood vessels were overestimated，and 4 segments of blood vessels are underestimated. The results of the two groups were consistent with the results of K=0.9546， which were highly consistent. Conclusion Enhanced MR angiography can be used as a reliable imaging method for the screening of diabetic lower extremity arterial stenosis. 　　[Key words] Enhanced MR; Vascular imaging; Diabetes; Lower extremity arterial stenosis; Digital subtraction angiography 　　糖尿病患者并发下肢动脉狭窄高非糖尿病患者10倍以上。下肢动脉狭窄症状可为下肢发冷、麻木、针刺样疼痛，严重时可有间歇性跛行、静息痛、查体可得下肢皮温下降、足背搏动消失等体征。但上述症状个体差异大，仅凭借临床经验易造成漏诊误诊。而糖尿病发病率逐年上升，下肢血管病变的发病率也将大大增加[1]。该院采用增强MR血管成像诊断糖尿病下肢动脉狭窄，现报道如下。 　　1 资料与方法 　　1.1 一般资料 　　选择2013年6月―2015年4月该院收治的糖尿病下肢动脉狭窄患者32例，其中男18例，女14例，年龄52～80岁，平均年龄（64.2±7.9）岁，糖尿病病程7～25年，平均（12.6±3.7）年。单侧检查28例，双侧检查4例，其中合并冠心病3例，糖尿病肾病2例。排除心、肝、肾等器官功能不全等疾病。