目的探讨DSA、CTA在下肢动脉狭窄或闭塞的影像学价值。方法对21例临床诊断下肢动脉硬化狭窄或闭塞的患者行DSA和CTA检查,比较两者动脉清晰度、管腔狭窄程度、敏感性、特征型、准确性和侧支循环显示情况,并分析其原因。结果在动脉清晰度上相比,CTA比DSA明显要好,但两者相比无明显差异(P≥0.05)。与DSA相比,在髂动脉型中有2例与DSA不符,在股腘动脉型中有4例与DSA不符,在小腿动脉型中有4例与DSA不符。与DSA相比,CTA过高估计了狭窄度,存在假阳性。在轻、中度狭窄两者相比统计学意义(P≥0.05),但在小腿动脉型中重度狭窄和完全闭塞两者相比有统计学意义(P≤0.05)。同时,其敏感性、特征性和准确性随着病变血管的变细而降低,有差别但无明星差异(P≥0.05)。侧支循环的显示随着病变血管的变细CTA与DSA相比越来越差。在DSA造影中,加大对比剂剂量和延长曝光时间后结果表明可提高阻塞病变远端血管和侧支循环的显示率。结论CTA越来越多的用于下肢动脉硬化狭窄或闭塞疾病初步诊断和筛选,但是,DSA仍是下肢动脉硬化狭窄或闭塞疾病诊断的首选。 Objective To investigate the imaging features of DSA and CTA in the stenosis or occlusion of lower extremity arteries. Methods DSA and CTA were performed in 21 patients with stenosis or occlusion of lower extremity arteriosclerosis. The arterial visibility, degree of stenosis, sensitivity, characteristic type, accuracy and collateral circulation were compared and analyzed the reason. Results CTA was significantly better than DSA in arterial resolution, but there was no significant difference between the two groups (P> 0.05). Compared with DSA, two of the iliac arteries did not agree with DSA, four of them were incompatible with DSA in femoral cartilage, and four of DSA with calf arteries. Compared with DSA, CTA overestimates the stenosis, there is a false positive. There was significant difference between mild and moderate stenosis (P≥0.05), but there was significant difference between moderate and severe stenosis and complete occlusion in lower leg arteries (P≤0.05). At the same time, its sensitivity, specificity and accuracy decreased with lessening of blood vessels of the lesion, but there was no difference between stars (P> 0.05). Collateral circulation is shown as CTA lesions become worse with lesser vascular lesions than DSA. In DSA angiography, increasing the contrast dose and prolonging the exposure time after the results showed that obstruction can increase the distal vascular and collateral circulation display rate. Conclusions CTA is more and more used in the diagnosis and screening of stenosis or occlusive disease of lower extremity arteriosclerosis. However, DSA is still the first choice for diagnosis of stenosis or occlusion of lower extremity arteriosclerosis.