目的 探讨64排螺旋CT血管成像 (CTA)在糖尿病下肢血管病变中的应用。 方法 选择2017年5月-2018年5月入院接 受下肢血管检查的糖尿病患者102例(血 管共计1850段)进行回顾性分析。所有患 者均接受CTA检查和多普勒彩超检查，以 数字减影血管造影(DSA)结果为金标准， 比较上述两种方法对糖尿病下肢病变的 敏感度、特异度、准确度和Kappa值；比 较CTA和DSA检测出糖尿病患者下肢血管 病变程度；记录CTA检查出血管病变的分 布情况。结果 与金标准(DSA)比，CTA对 下肢血管病变的灵敏度为0.961，特异 度为0.792，准确度为0.916，Kappa值 为0.778，均大于多普勒彩超检查(灵敏 度为0.849，特异度为0.566，准确度为 0.773，Kappa值为0.417)；CTA对糖尿病 患者下肢血管病变轻度狭窄、中度狭窄、 重度狭窄和闭塞的检出率与DSA比较， 差异无统计学意义(P>0.05)；经研究， 31.37%(32/102)的患者表现为腘动脉狭 窄或闭塞，29.41%(30/102)的患者表现 为股动脉狭窄或闭塞，12.75%(13/102) 的患者表现为腹主动脉狭窄或闭塞， 14.71%(15/102)的患者表现为小腿动脉狭 窄或闭塞，11.76%(12/102)的患者表现髂 动脉狭窄或闭塞。结论 64排CTA对糖尿病 患者下肢血管病变检测结果较为可靠，敏 感度及特异度较高，能准确反映患者血管 病变情况。

Objective To investigate the application of 64-slice spiral CT angiography (CTA) in diabetic lower extremity vascular disease. Methods A total of 102 cases of patients with diabetes mellitus (a total of 1850 vessels) who underwent lower extremity vascular examination from May 2017 to May 2018 were analyzed retrospectively. All patients were given CTA and color Doppler ultrasound. The digital subtraction angiography (DSA) results were used as the gold standard to compare the sensitivity, specificity, accuracy and Kappa value of the two methods. The degree of lower extremity vascular disease of diabetic patients detected by CTA and DSA was compared. The distribution of vascular disease was recorded by CTA. Results Compared with the gold standard (DSA), the sensitivity, specificity, accuracy and the Kappa value of CTA in lower extremity vascular disease were 0.961, 0.792, 0.916 and 0.778, which were greater than those of color Doppler ultrasound with 0.849, 0.566, 0.773 and 0.417. There was no significant difference between CTA and DSA in the detection rates of mild stenosis, moderate stenosis, severe stenosis and occlusion of lower extremity vascular disease in diabetic patients (P>0.05). By study, 31.37% (32/102) patients showed popliteal artery stenosis or occlusion, and 29.41% (30/102) patients showed femoral artery stenosis or occlusion, and 12.75% (13/102) patients showed abdominal aorta stenosis or occlusion, and 14.71% (15/102) patients showed stenosis or occlusion of calf artery, and 11.76% (12/102) patients showed stenosis or occlusion of iliac artery. Conclusion 64-slice CTA is reliable for the detection of lower extremity vascular disease in diabetic patients, and it has high sensitivity and specificity, and can accurately reflect the vascular lesions of patients.