The Evaluation Of Lower Extremity Arterial Occlusive Disease Of Diabetes Combining Hypertension With MSCTA

ObjectiveTo provide an objective evidence for early clinical diagnosis and treatment of lower limb arteriosclerosis obliterans via analysing the image characteristics of lower extremity arterial MSCTA of diabetic patients with hypertension.Methods100 Clinically diagnosed patients with arteriosclerosis obliterans were collected.They were divided Divided into diabetic group(DM), 32 cases; hypertension (HBP), 31 cases; and diabetes with hypertension (DM + HBP), 37 cases. Lower limb artery CTA was practiced among them by multi-slice spiral CT(MSCT). Lower limb artery was divided into 12 segments by 12 sub-integration of arteriography. Luminal stenosis of every Segmental arterie was measured, and Detection rate and character of plaque every vessel segment was observated. These were statistical analysed that Luminal stenosis integral, detection rate and character of plaque. 20 patients (DM group 7 cases, HBP group of 7 cases and 6 cases of DM + HBP group) after the MSCTA scan within 2 weeks,then without digital subtraction angiography(DSA) before treatment. DSA as the gold standard to evaluate the diagnostic accuracy of MSCT.ResultsAll patients were satisfied with the MSCT angiograms: 1,The sensitivity, specificity and accuracy of MSCTA diagnosis of lower extremity arterial stenosis were 99.5%, 97.0% and 98.3%.The sensitivity, specificity and accuracy of MSCTA clinical significance of lower extremity arterial stenosis (vessel stenosis≥50%) were 99.7%, 99.3% and 99.5%.2,Three groups of artery lesions in the knee or above stenosis had no significant difference(P>0.05).Three groups of vascular plaque was no significant difference (P>0.05), mainly on mixed plaque.3,The following small artery in the knee lesions,The narrow points of DM + HBP group was significantly higher than DM group (P<0.05) and the HBP group (P<0.05),there were significant differences. And the detection rate of plaque of DM + HBP group was higher than that DM group (P<0.05) and the HBP group (P<0.05), mainly in calcified plaque.Conclusions1,MSCTA can make a clear diagnosis of arteriosclerosis obliterans of lower limbs.2,DM + HBP patients with lower extremity arterial occlusive disease were more severe than that of DM and HBP. The terminal vascular involvement below-knee was significantly, mainly in calcified plaque. The vascular involvement below-knee of DM patients was more serious than HBP patients.