Gao Yapeng, Ma Jingwei, Lu Tingbin, Qi Juan
Department of Medical Imaging, Shaanxi Kangfu Hospital No. 52, Electronic 2nd Road, Electronic City, Xi'an 710065, Shaanxi, China.
Am J Transl Res. 2024 Nov 15;16(11):7136-7144. doi: 10.62347/VAFX9854. eCollection 2024.
To evaluate the efficacy and safety of 128 slice CT low-dose scanning technology combined with low-density contrast agent in lower extremity computed tomography angiography (CTA) for patients with diabetic foot.
A retrospective study was conducted on 342 patients with diabetic foot admitted to Shaanxi Kangfu Hospital from March 2021 to May 2023. Of these, 181 received 128 slice CT low-dose scanning technology combined with low-density contrast medium for lower extremity CTA examination (research group), and 161 patients underwent conventional dose contrast medium for CTA examination (control group). Diagnostic outcomes of the two groups were compared, along with image quality, contrast agent dosage, patient tolerance to contrast agents, and incidence of adverse reactions.
No significant difference was observed in diabetic foot detection rate between the two groups (90.06% in research group vs. 86.96% in control group, P > 0.05). No significant difference in image quality or vascular CT values was found between the two groups (P > 0.05). Although the research group exhibited slightly higher image noise and lower signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), these differences were not significant (all P > 0.05). The volume computed tomography dose index (CTDIvol), effective dose (ED), and iodine uptake in the research group were significantly lower than those of the control group (all P < 0.05). In terms of the incidence of adverse reactions, patients in the research group had a good tolerance to contrast agents, with an 8.29% incidence of mild discomfort (such as nausea and mild rash) and no reports of severe allergic reactions. In contrast, the incidence of mild discomfort reactions in the control group was 14.91% (P < 0.05). Among the diabetic foot patients, 46.20% had mild stenosis, while 53.80% had moderate-to-severe stenosis. The detection rate of moderate-to-severe stenosis was 84.67% (138/163) in the research group and 82.86% (116/140) in the control group (P > 0.05). The ROC curve results indicated good diagnostic accuracy in both groups (AUC of 0.690 in research group and 0.783 in control), with significant difference between the two groups (P > 0.05).
128 slice CT low-dose scanning technology combined with low concentration contrast medium shows good effectiveness and safety for CTA of lower limbs in patients with diabetic foot. It provides an optimized scheme for vascular assessment of diabetic foot patients, reducing contrast agent exposure, lowering the risk of complications, and maintaining diagnostic accuracy.
评估128层CT低剂量扫描技术联合低密度对比剂在糖尿病足患者下肢计算机断层血管造影（CTA）中的有效性和安全性。
对2021年3月至2023年5月在陕西康复医院收治的342例糖尿病足患者进行回顾性研究。其中，181例接受128层CT低剂量扫描技术联合低密度对比剂进行下肢CTA检查（研究组），161例患者接受常规剂量对比剂进行CTA检查（对照组）。比较两组的诊断结果、图像质量、对比剂用量、患者对对比剂的耐受性及不良反应发生率。
两组糖尿病足检出率差异无统计学意义（研究组为90.06%，对照组为86.96%，P>0.05）。两组图像质量及血管CT值差异无统计学意义（P>0.05）。虽然研究组图像噪声略高，信噪比（SNR）和对比噪声比（CNR）略低，但差异均无统计学意义（均P>0.05）。研究组容积计算机断层剂量指数（CTDIvol）、有效剂量（ED）及碘摄取量均显著低于对照组（均P<0.05）。在不良反应发生率方面，研究组患者对对比剂耐受性良好，轻度不适（如恶心、轻度皮疹）发生率为8.29%，无严重过敏反应报告。相比之下，对照组轻度不适反应发生率为14.91%（P<0.05）。在糖尿病足患者中，46.20%为轻度狭窄，53.80%为中重度狭窄。研究组中重度狭窄检出率为84.67%（138/163），对照组为82.86%（116/140）（P>0.05）。ROC曲线结果表明两组诊断准确性均良好（研究组AUC为0.690，对照组为0.783），两组间差异有统计学意义（P>0.05）。
128层CT低剂量扫描技术联合低浓度对比剂对糖尿病足患者下肢CTA检查具有良好的有效性和安全性。为糖尿病足患者血管评估提供了优化方案，减少了对比剂暴露，降低了并发症风险，同时保持了诊断准确性。
