Zhang Shujun, Su Yanfei, Chen Haisong
Department of Radiology, The Affiliated Hospital of Qingdao University , Qingdao , China.
Department of Ultrasound, The First People Hospital of Jining , Jining , China.
Br J Radiol. 2017 Aug;90(1077):20170016. doi: 10.1259/bjr.20170016. Epub 2017 Jul 14.
To study the value of a retrograde flow sign and the collateral circulation on CT angiography (CTA) for the differential diagnosis of chronic total occlusion from subtotal occlusion of the femoropopliteal artery (FPA). 50 patients with obstruction of the FPA underwent CTA and digital subtraction angiography examinations of the lower limbs. The frequency of a retrograde flow sign and collateral circulation on CTA in chronic total and subtotal occlusion was noted and analyzed, with the results of digital subtraction angiography as a standard to judge total or subtotal occlusion. The decreasing CT value from the distal to proximal direction on CTA suggests the existence of retrograde flow.
There were significant differences in the occurrence rates of a retrograde flow sign on CTA in the chronic total and subtotal obstruction groups (X = 13.1, p < 0.05), as well as a collateral circulation sign (X = 13.5, p < 0.05). Employing both the retrograde flow sign and the collateral circulation sign to diagnose chronic total obstruction of the FPA had a sensitivity of 92.3% and specificity of 89.8%.
The retrograde flow sign combined with a collateral circulation sign is of great clinical value for differentiation of chronic total stenosis from severe stenosis (subtotal occlusion) of the FPA. Advances in knowledge: A retrograde flow sign combined with a collateral circulation sign is of great clinical value to differentiate between chronic total stenosis and severe stenosis (subtotal occlusion) of the FPA.
探讨CT血管造影（CTA）上的逆向血流信号及侧支循环对股腘动脉（FPA）慢性完全闭塞与次全闭塞进行鉴别诊断的价值。50例FPA闭塞患者接受了下肢CTA及数字减影血管造影检查。记录并分析慢性完全闭塞和次全闭塞CTA上逆向血流信号及侧支循环的出现频率，以数字减影血管造影结果作为判断完全闭塞或次全闭塞的标准。CTA上从远心端到近心端CT值降低提示存在逆向血流。
慢性完全闭塞组与次全闭塞组CTA上逆向血流信号的发生率（X = 13.1，p < 0.05）以及侧支循环信号的发生率（X = 13.5，p < 0.05）存在显著差异。采用逆向血流信号和侧支循环信号诊断FPA慢性完全闭塞的敏感度为92.3%，特异度为89.8%。
逆向血流信号联合侧支循环信号对鉴别FPA慢性完全狭窄与严重狭窄（次全闭塞）具有重要临床价值。知识进展：逆向血流信号联合侧支循环信号对鉴别FPA慢性完全狭窄与严重狭窄（次全闭塞）具有重要临床价值。
