Ferrer M D, Revert A J, Pallardó Y, Esteban E, Jornet J, Mollá E
Servicio de Radiología, Hospital de la Ribera, Alzira, Valencia, España.
Radiologia. 2006 Nov-Dec;48(6):369-74. doi: 10.1016/s0033-8338(06)75152-9.
To evaluate the diagnostic efficacy of multidetector computed tomography angiography (MDCTA) in lower limb arteriopathy (LLA) by comparing it with digital subtraction angiography (DSA).
Twenty-four patients with LLA were studied. All patients underwent MDCTA (four detectors) and DSA, with double reading between the two techniques. Vascular territories were divided to facilitate analysis. Sensitivity (S), specificity (Sp), prevalence, positive and negative predictive values (PPV, PNV), and concordance (Kappa test) were evaluated. In third-portion arteries, the diagnostic performance of MDCTA was evaluated using an ROC curve.
MDCTA study to evaluate arterial pathology showed: Lower sensitivity in the study of the internal iliac artery (S: 0.65 and 0.71) with Sp 0.94 and 1. In the other vascular territories, S approached 1, with a slight decrease in Sp. Concordance with DSA was very high (kappa between 0.62 and 1) in all of the territories studied. MDCTA showed greater vessel longitude than DSA. In the third portion, the best diagnostic performance (ROC) was obtained in the reading of pathological vessels.
MDCTA was highly reliable in the study of LLA, with high concordance with DSA. In tortuous vessels, MDCTA depicted the lesions poorly; however, in straight vessels and third-portion vessels, MDCTA showed more vascular segments.
通过与数字减影血管造影(DSA)比较,评估多排螺旋CT血管造影(MDCTA)对下肢动脉病变(LLA)的诊断效能。
对24例LLA患者进行研究。所有患者均接受MDCTA(四排探测器)和DSA检查,并对两种技术进行双读。划分血管区域以方便分析。评估敏感性(S)、特异性(Sp)、患病率、阳性和阴性预测值(PPV、PNV)以及一致性(kappa检验)。在第三段动脉中,使用ROC曲线评估MDCTA的诊断性能。
MDCTA评估动脉病变的研究显示:在髂内动脉研究中敏感性较低(S分别为0.65和0.71),Sp分别为0.94和1。在其他血管区域,S接近1,Sp略有下降。在所有研究区域中,与DSA的一致性非常高(kappa值在0.62至1之间)。MDCTA显示的血管长度比DSA更长。在第三段,对病变血管的解读获得了最佳诊断性能(ROC)。
MDCTA在LLA研究中高度可靠,与DSA一致性高。在迂曲血管中,MDCTA对病变的显示较差;然而,在直血管和第三段血管中,MDCTA显示的血管节段更多。