踝臂指数<0.9会低估老年人群中通过全身磁共振血管造影评估的外周动脉闭塞性疾病的患病率。

Ankle brachial index <0.9 underestimates the prevalence of peripheral artery occlusive disease assessed with whole-body magnetic resonance angiography in the elderly.

作者信息

Wikström J, Hansen T, Johansson L, Lind L, Ahlström H

机构信息

Department of Radiology and Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden.

出版信息

Acta Radiol. 2008 Mar;49(2):143-9. doi: 10.1080/02841850701732957.

DOI:10.1080/02841850701732957

PMID:18300136

Abstract

BACKGROUND

Whole-body magnetic resonance angiography (WBMRA) permits noninvasive vascular assessment, which can be utilized in epidemiological studies.

PURPOSE

To assess the relation between a low ankle brachial index (ABI) and high-grade stenoses in the pelvic and leg arteries in the elderly.

MATERIAL AND METHODS

WBMRA was performed in a population sample of 306 subjects aged 70 years. The arteries below the aortic bifurcation were graded after the most severe stenosis according to one of three grades: 0-49% stenosis, 50-99% stenosis, or occlusion. ABI was calculated for each side.

RESULTS

There were assessable WBMRA and ABI examinations in 268 (right side), 265 (left side), and 258 cases (both sides). At least one > or =50% stenosis was found in 19% (right side), 23% (left side), and 28% (on at least one side) of the cases. The corresponding prevalences for ABI <0.9 were 4.5%, 4.2%, and 6.6%. An ABI cut-off value of 0.9 resulted in a sensitivity, specificity, and positive and negative predictive value of 20%, 99%, 83%, and 84% on the right side, and 15%, 99%, 82%, and 80% on the left side, respectively, for the presence of a > or =50% stenosis in the pelvic or leg arteries.

CONCLUSION

An ABI <0.9 underestimates the prevalence of peripheral arterial occlusive disease in the general elderly population.

摘要

背景

全身磁共振血管造影（WBMRA）可进行无创血管评估，可用于流行病学研究。

目的

评估老年人群中低踝臂指数（ABI）与盆腔及腿部动脉重度狭窄之间的关系。

材料与方法

对306名70岁的人群样本进行WBMRA检查。根据最严重狭窄程度将主动脉分叉以下动脉分为三个等级之一：0 - 49%狭窄、50 - 99%狭窄或闭塞。计算每侧的ABI。

结果

268例（右侧）、265例（左侧）和258例（双侧）可进行WBMRA和ABI检查。19%（右侧）、23%（左侧）和28%（至少一侧）的病例发现至少一处≥50%的狭窄。ABI<0.9的相应患病率分别为4.5%、4.2%和6.6%。对于盆腔或腿部动脉存在≥50%的狭窄，ABI临界值为0.9时，右侧的敏感性、特异性、阳性预测值和阴性预测值分别为20%、99%、83%和84%，左侧分别为15%、99%、82%和80%。