【摘要】 目的 探讨三维对比剂增强磁共振血管造影(3D CE-MRA)在糖尿病足病(DF)下肢动脉病变检查中的应用价值，分析DF下肢动脉病变特点。方法 对46例DF和39例非糖尿病单纯下肢动脉硬化(NDM)患者行CE-MRA检查，分析各动脉节段狭窄(≥50%)累计频度和狭窄积分，以NDM组为对照分析DF组动脉病变特点;以DSA为金标准分析CE-MRA的准确性。结果 就动脉狭窄累及频度和积分而言，DF组远端动脉有高于近端的趋势,伴足部病变与不伴足部病变下肢之间无统计学差异;在膝以上动脉，DF组与NDM组无统计学差异;在膝以下动脉，DF组明显高于NDM组。CE-MRA诊断动脉狭窄(≥50%)的灵敏度、特异度及准确度分别为97.85%，84.85%，94.44%。结论 3D CE-MRA能较准确显示DF患者下肢动脉病变;与NDM相比，DF更易累及膝以下动脉，且下肢动脉病变与足部病变并不完全一致。

　　【关键词】 磁共振血管成像术; 三维成像; 糖尿病足

　　作者单位：100036 北京空军总医院CT&MR室(孟利民、宋云龙、张挽时、毕永民、方红、祝红线);北京空军总医院糖尿病中心(肖黎)

　　Study of lower extremity arterial disease in diabetic foot patients by 3D CE-MRA MENG Li - min , SONG Yun - long , ZHANG Wan - shi ,et al.Department of CT&MR, Air Force General Hospital, Beijing 100036, China

　　【Abstract】 Objective To study the diagnostic value of 3D contrast enhancement magnetic resonance angiography(3D CE-MRA) of lower extremity in diabetic foot(DF) patients ,and to evaluate the characteristics of peripheral arteries disease. Methods Bilateral lower extremities in 46 DF patients (DF group) and 39 non-diabetes mellitus patients(NDM group) accepted the CE-MRA examination.The prevalence of stenosis and angiographic scores in DF group were analyzed and compared to NDM group. Digital subtraction angiography (DSA) data was used as “golden standard” to identify the accuracy of CE-MRA. Results As to the prevalence of stenosis and the angiographic score, the distal peripheral arteries tended to have higher scores than proximal arteries in DF group;there was no significant difference between the limbs with and without DF, as well as in arteries above the knee between DF and NDM groups.However, in arteries below the knee, DF group tended to have higher values than NDM cases.The sensitivity, specificity and accuracy of CE-MRA for stenosis(≥50%) was 97.85%,84.85% and 94.44%,respectively. Conclusion 3D CE-MRA is valuable to exam lower extremity arterial disease in DF patients. In DF group, the arteries disease below the knee tended to be more often and severe than that of NDM group. Diabetic foot was not consistent with the degree of vascular disease.

　　【Key words】 Magnetic resonance angiography ; Three-demensional image;Diabetic foot