下肢动脉硬化闭塞症的诊断方法

近些年下肢动脉硬化闭塞症(LEASD)在国内外发病率均明显上升。其诊断方法很多,包括动脉造影、彩色超声多普勒、核磁共振血管造影、计算机断层血管造影和多功能周围血管检查等。动脉造影做为诊断动脉病变的金标准,因其价格相对昂贵,技术复杂,在临床应用上有一定的局限性;彩色多普勒超声操作简便,无创伤、可重复,临床应用较多,但不能直观的提供病变血管的形态;新近发展的核磁共振血管造影和计算机断层血管造影无创伤、可重复、分辨率高,且可直观的提供病变血管的形态,发展前景广阔;PVL作为一种无损伤血管检查,可进行多普勒血流图形描记和节段性测压,在判断下肢动脉狭窄闭塞性病变方面与彩色超声相关性好,准确性高,可在LEASD病人的门诊初步筛选、病情估计和随访等方面推广应用。

Current methods of Diagnosis on the Low Extremity Arteriosclerosis Disease

The attack rate of Low Extremity Arteriosclerosis Disease(LEASD)has risen greatly in recent years.Many devices have been applied to the diagnosis of it,such as digital subtraction angiography(DSA),color doppler ultrasound(CDU), magnetic resonance angiograph(MRA),computed tomography angiography(CTA)and personal vascular laboratory(PVL).DSA, as the diagnostic gold standard of artery diseases,has its clinical limitations because of its high price and complicated technique. CDU is widely applied in clinic for its easy operation,non-invasion and repeatability.However,it can't reflect directly the shape of the pathological vessels,which has stood on its way to make more progress.MRA and CTA have been developed in recent years. They not only can be applied to patients non-invasively and repeatedly,but also can reflect pathological vessels directly and precisely.What's more,it is easier to operate.Besides,PVL can record bloodstream patterns and sectionalized blood pressure.As a Doppler noninvasive vascular test,PVL gives a high accuracy and safety on evaluation of aged patients with lower extremity arterial occlusive disease,and can be commonly used as the first line objective modality to confirm the diagnosis,establish the severity of ischemia,and screen for potential complications in patients.