Department of General Surgery, Singapore General Hospital, Singapore 169608.
Singapore Med J. 2013 May;54(5):271-4. doi: 10.11622/smedj.2013107.
The gold standard for evaluation of the lower extremity arterial tree is catheter angiography. Duplex arterial-occlusive imaging or duplex ultrasonography arteriography, a noninvasive technique, is used as the first-line investigation in patients with peripheral vascular disease at our centre. Based on the results of duplex imaging, patients who require angiographic intervention then proceed with simultaneous catheter arteriography and intervention. This study aimed to compare the results of duplex imaging alone as the first-line investigation against the eventual results of catheter angiography, and to assess the impact of the former on patients' clinical outcomes.
All cases involving patients who underwent duplex imaging followed by angiographic intervention, from May 2008 to February 2009, were discussed at weekly interdisciplinary meetings. Only patients who underwent lower limb imaging were included in the study. Those who were involved in grafts and stent surveillance studies, as well as those with incomplete duplex images were excluded.
During the study period, 113 duplex imaging studies of the lower limb followed by percutaneous transluminal angioplasty were performed at our hospital for peripheral vascular disease. The iliac artery was visualised in 40 images, but could not be visualised in 73 images. There was a potential change in management in three cases due to radiological differences between the duplex images and angiography films.
In our series, duplex imaging was found to be accurate enough to guide initial clinical management of patients with peripheral vascular disease. This modality is the preferred first-line investigation for such patients at our centre.
评估下肢动脉树的金标准是导管血管造影术。在我们中心，对于外周血管疾病患者，作为一线检查方法使用非侵入性技术——双功能动脉闭塞成像或双功能超声血管造影术。根据双功能成像的结果，需要血管造影介入的患者随后进行同时导管血管造影和介入。本研究旨在比较单独进行双功能成像作为一线调查的结果与导管血管造影的最终结果，并评估前者对患者临床结果的影响。
所有涉及在我们中心进行双功能成像后进行血管造影介入的病例，在 2008 年 5 月至 2009 年 2 月期间每周进行一次跨学科讨论。本研究仅纳入进行下肢成像的患者。那些参与移植物和支架监测研究以及双功能成像不完整的患者被排除在外。
在研究期间，我院对 113 例外周血管疾病患者进行了下肢经皮腔内血管成形术的双功能成像检查。在 40 个图像中可以观察到髂动脉，但在 73 个图像中无法观察到髂动脉。由于双功能图像和血管造影胶片之间存在放射学差异，有 3 例患者的管理可能发生改变。
在我们的系列研究中，双功能成像足以准确指导外周血管疾病患者的初始临床管理。这种方式是我们中心此类患者的首选一线检查方法。
