iFlow彩色血流编码成像技术在下肢动脉硬化闭塞症诊断中的应用价值

doi:10.3969/j.issn.1006-5725.2024.18.020

摘要/Abstract

摘要：

目的研究iFlow彩色血流编码成像技术在下肢动脉硬化闭塞症（LEASO）诊断中的应用价值。方法选择2022年3月至2023年10月期间确诊的106例LEASO患者作为本研究的LEASO组，以一般资料与LEASO组匹配且无动脉病变的80例志愿者作为对照组。两组受试者均进行数字减影血管造影（DSA）并采用iFlow彩色血流编码成像技术检测股骨头区域和踝关节区域达峰时间（TTP）、计算踝关节区域与股骨头区域 TTP的差值，测量踝肱指数（ABI）。结果两组研究对象年龄、性别、体质量指数、吸烟史、高血压病史、糖尿病史、冠心病史、股骨头区域TTP的比较，差异无统计学意义（P > 0.05）；LEASO组踝关节区域TTP及TTP差值均高于对照组，差异有统计学意义（P < 0.05）；LEASO组中不同Rutherford分类患者股骨头区域TTP的比较以及左侧病变患者与右侧病变患者股骨头区域TTP、踝关节区域TTP、TTP差值的比较，差异无统计学意义（P > 0.05），Rutherford分类越高，踝关节区域TTP及TTP差值越低（P < 0.05）；经Pearson检验，LEASO患者的踝关节区域TTP、TTP差值与ABI呈负相关（P < 0.05）；经受试者工作特征（ROC）曲线分析，踝关节区域TTP、TTP差值对LEASO具有诊断效能；经Delong检验，TTP差值诊断的ROC曲线下面积高于踝关节区域TTP（P < 0.05）。结论 iFlow彩色血流编码成像技术测定踝关节区TTP及TTP差值是诊断LEASO的量化指标。

关键词: 下肢动脉硬化闭塞症, iFlow彩色血流编码成像技术, 达峰时间, 踝关节

Abstract:

Objective To investigate the clinical utility of iFlow color flow coding imaging technology in the diagnosis of lower extremity arteriosclerosis obliterans （LEASO）. Methods A total of 106 patients diagnosed with LEASO between March 2022 and October 2023 were included as the LEASO group， while 80 volunteers without arterial disease but matched with LEASO were selected as the control group. Both groups underwent digital subtraction angiography （DSA）， and iFlow color flow coding imaging technology was employed to assess time to peak （TTP） in the femoral head and ankle regions. The difference value of TTP between these two regions was calculated， along with measurement of ankle-brachial index （ABI）. Results There were no significant differences in age， sex， body mass index， smoking history， hypertension history， diabetes history， coronary heart disease history and TTP in the femoral head between the two groups （P > 0.05）. However， the TTP in the ankle area and the difference values of TTP in the LEASO group were significantly higher than those in the control group （P < 0.05）. The comparison of TTP in the femoral head region among patients with different Rutherford classifications and between patients with left and right lesions in the LEASO group showed no statistical significance （P > 0.05）. Furthermore， a negative correlation was observed between Rutherford classification and both TTP values in ankle joint region as well as TTP difference value （P < 0.05）， indicating that higher Rutherford classification is associated with lower TTP values. Pearson test results revealed a significant negative correlation between TTP values and ankle joint region/TTP difference value of LEASO patients with ABI （ P < 0.05）. Receiver operating characteristic curve analysis demonstrated that both TTP values in ankle joint region and TTP difference value are effective diagnostic indicators for LEASO； moreover， Delong test indicated that area under ROC curve for TTP difference value was significantly higher than that for TTP value alone （P < 0.05） Conclusion iFlow color flow coding imaging technology enables quantitative assessment of both TPP values within ankle joint region as well as their differences which can be utilized for diagnosis of LEASO.

Key words: arteriosclerosis obliterans of lower extremity, iFlow color flow coding imaging technology, time to peak, ankle joint

中图分类号:

R654.4

龙海灯,殷世武,潘升权,项廷淼,宋均飞,王元. iFlow彩色血流编码成像技术在下肢动脉硬化闭塞症诊断中的应用价值[J]. 实用医学杂志, 2024, 40(18): 2623-2628.

Haideng LONG,Shiwu YIN,Shengquan PAN,Tingmiao XIANG,Junfei SONG,Yuan. WANG. Application value of iFlow color flow coding imaging technology in diagnosis of arteriosclerosis obliterans of lower limbs[J]. The Journal of Practical Medicine, 2024, 40(18): 2623-2628.

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组别	例数	年龄（x ± s）/岁	性别（男/女）	体质量指数（x ± s）/（kg/m²）	吸烟史	高血压	糖尿病	冠心病
LEASO组	106	67.41 ± 7.58	62/44	22.41 ± 3.04	42	64	42	24
对照组	80	66.38 ± 6.57	41/39	22.28 ± 2.85	22	38	21	11
t/χ ² 值		0.971	0.967	0.297	2.969	3.058	2.319	2.359
P值		0.333	0.325	0.767	0.085	0.081	0.128	0.125

组别	例数	股骨头区域TTP	踝关节区域TTP	TTP差值
LEASO组	106	4.35 ± 0.49	23.51 ± 3.18	19.16 ± 3.09
对照组	80	4.41 ± 0.58	13.05 ± 3.42	8.65 ± 1.06
t值		0.764	21.499	29.139
P值		0.446	< 0.001	< 0.001

Rutherford分类	例数	股骨头区域TTP	踝关节区域TTP	TTP差值
0	7	4.30 ± 0.72	19.40 ± 4.45	15.10 ± 3.82
Ⅰ	10	4.28 ± 0.64	21.16 ± 2.37	16.88 ± 2.15
Ⅱ	12	4.33 ± 0.68	22.48 ± 3.07^?	18.15 ± 3.00^?
Ⅲ	39	4.30 ± 0.38	23.31 ± 1.83^?a	19.00 ± 1.94^?a
Ⅳ	23	4.43 ± 0.45	24.60 ± 3.16^?ab	20.16 ± 3.14^?ab
Ⅴ	8	4.41 ± 0.41	25.81 ± 2.01^?abc	21.40 ± 1.92^?abc
Ⅵ	7	4.47 ± 0.54	27.64 ± 2.39^?abcd	23.17 ± 2.42^?abcd
F值		0.315	9.105	9.060
P值		0.928	< 0.001	< 0.001

病变特征	例数	股骨头区域TTP	踝关节区域TTP	TTP差值
左侧病变	58	4.34 ± 0.41	23.29 ± 2.98	18.95 ± 2.95
右侧病变	48	4.37 ± 0.58	23.77 ± 3.41	19.40 ± 3.27
t值		0.311	0.773	0.742
P值		0.756	0.441	0.460