Bo Ying, Xie Jia, Xu Fan, Yang Guo, Li Dong-Ling, Yan Xiao-Hang
Department of Radiology, Chongqing Kang Hua Zhong Lian Cardiovascular Hospital, Chongqing 400025, China.
Central Laboratory of Chongqing Emergency Medical Center, Chongqing University Central Hospital, School of Medicine, Chongqing University, Chongqing 400014, China.
World J Diabetes. 2025 Jul 15;16(7):107187. doi: 10.4239/wjd.v16.i7.107187.
Underdiagnosis of peripheral arterial disease results in inadequate treatment and more serious consequences. Hence, clinicians have focused on early diagnosis and treatment.
To investigate the effectiveness of the combination of doppler ultrasonography (DUS), three-dimensional dynamic contrast-enhanced magnetic resonance angiography (CE-MRA), and CT angiography (CTA) in assessing lower extremity arterial disease in diabetes mellitus (DM).
This study retrospectively analyzed the imaging and clinical data of 116 patients diagnosed with DM complicated with lower extremity vascular diseases from January 2021 to June 2023. All patients underwent unilateral or bilateral DUS, CTA, and CE-MRA as well as invasive digital subtraction angiography (DSA). The application values of DUS, CE-MRA, and CTA were compared.
A total of 152 lower extremity arteries in the 116 patients were graded following the classification of vascular branches. The Kappa values between DUS and DSA were 0.780, 0.755, and 0.806 for diagnosing moderate stenosis and 0.484, 0.699, and 0.449 for severe stenosis of grade 1 arteries, grade 2 arteries, and grade 3 arteries, respectively. The Kappa values between CE-MRA and DSA were 0.784, 0.814, and 0.835 for diagnosing moderate stenosis and 0.694, 0.748, and 0.606 for severe stenosis of grade 1 arteries, grade 2 arteries, and grade 3 arteries, respectively. The Kappa values between CTA and DSA were 0.900, 0.858, and 0.878 for diagnosing moderate stenosis and 0.882, 0.823, and 0.756 for severe stenosis of grade 1 arteries, grade 2 arteries, and grade 3 arteries, respectively.
DUS, CE-MRA, and CTA demonstrated comparable accuracy in diagnosing lower extremity arterial disease in DM, and the consistency between CTA and DSA diagnoses was higher than the other two imaging methods.
外周动脉疾病的诊断不足会导致治疗不充分及更严重的后果。因此，临床医生一直专注于早期诊断和治疗。
探讨多普勒超声（DUS）、三维动态对比增强磁共振血管造影（CE-MRA）和CT血管造影（CTA）联合应用在评估糖尿病（DM）患者下肢动脉疾病中的有效性。
本研究回顾性分析了2021年1月至2023年6月期间116例诊断为DM合并下肢血管疾病患者的影像学和临床资料。所有患者均接受了单侧或双侧DUS、CTA、CE-MRA以及有创数字减影血管造影（DSA）检查。比较了DUS、CE-MRA和CTA的应用价值。
116例患者的152条下肢动脉按照血管分支分类进行分级。DUS与DSA诊断1级动脉、2级动脉和3级动脉中度狭窄的Kappa值分别为0.780、0.755和0.806，诊断重度狭窄的Kappa值分别为0.484、0.699和0.449。CE-MRA与DSA诊断1级动脉、2级动脉和3级动脉中度狭窄的Kappa值分别为0.784、0.814和0.835，诊断重度狭窄的Kappa值分别为0.694、0.748和0.606。CTA与DSA诊断1级动脉、2级动脉和3级动脉中度狭窄的Kappa值分别为0.900、0.858和0.878，诊断重度狭窄的Kappa值分别为0.882、0.823和0.756。
DUS、CE-MRA和CTA在诊断DM患者下肢动脉疾病方面具有相当的准确性，且CTA与DSA诊断之间的一致性高于其他两种成像方法。
