中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2009年
15期
1385-1386,1389
,共3页
体层摄影术%螺旋计算机%脑梗死%颈动脉狭窄%血管造影术%数字减影
體層攝影術%螺鏇計算機%腦梗死%頸動脈狹窄%血管造影術%數字減影
체층섭영술%라선계산궤%뇌경사%경동맥협착%혈관조영술%수자감영
Tomography,spiral computed%Brain infarction%Carotid stenosis%Angiography,digital subtraction
目的 数字减影血管造影(DSA)是诊断颈动脉血管狭窄的金标准,本研究旨在评价多层螺旋CT血管造影(CTA)对颈动脉狭窄的诊断价值及与DSA的吻合程度.方法 选择42例临床怀疑颈动脉狭窄患者行CTA和DSA检查,CTA后处理采用多维容积再现(volume rendering,VR)和最大强度投影(maximum intensity projection,MIP)技术,对血管狭窄程度进行分析.结果 CTA检查与DSA检查比较,颈动脉Ⅰ度狭窄的检出率间差异有统计学意义(χ2=4.71,P＜0.05),Ⅱ～Ⅳ度狭窄的检出率间差异无统计学意义(P＞0.05);CTA诊断颈动脉Ⅰ度狭窄的敏感度(Se)69.2%、特异度(Sp)95.3%、符合率(π)85.5%、误诊率(α)4.7%、漏诊率(β)30.1%;Ⅱ度狭窄的Se 82.1%、Sp 97.6%、π 91.3%、α 2.4%、β 17.9%;Ⅲ及Ⅳ度狭窄的Se 93.3%、Sp 98.1%、π 97.1%、α 1.9%、β 6.7%.结论 颈部血管CTA检查有较高的灵敏度和特异度,与DSA检查吻合程度好,是一种有效、安全、无创的检查手段,值得临床推广应用.
目的 數字減影血管造影(DSA)是診斷頸動脈血管狹窄的金標準,本研究旨在評價多層螺鏇CT血管造影(CTA)對頸動脈狹窄的診斷價值及與DSA的吻閤程度.方法 選擇42例臨床懷疑頸動脈狹窄患者行CTA和DSA檢查,CTA後處理採用多維容積再現(volume rendering,VR)和最大彊度投影(maximum intensity projection,MIP)技術,對血管狹窄程度進行分析.結果 CTA檢查與DSA檢查比較,頸動脈Ⅰ度狹窄的檢齣率間差異有統計學意義(χ2=4.71,P＜0.05),Ⅱ～Ⅳ度狹窄的檢齣率間差異無統計學意義(P＞0.05);CTA診斷頸動脈Ⅰ度狹窄的敏感度(Se)69.2%、特異度(Sp)95.3%、符閤率(π)85.5%、誤診率(α)4.7%、漏診率(β)30.1%;Ⅱ度狹窄的Se 82.1%、Sp 97.6%、π 91.3%、α 2.4%、β 17.9%;Ⅲ及Ⅳ度狹窄的Se 93.3%、Sp 98.1%、π 97.1%、α 1.9%、β 6.7%.結論 頸部血管CTA檢查有較高的靈敏度和特異度,與DSA檢查吻閤程度好,是一種有效、安全、無創的檢查手段,值得臨床推廣應用.
목적 수자감영혈관조영(DSA)시진단경동맥혈관협착적금표준,본연구지재평개다층라선CT혈관조영(CTA)대경동맥협착적진단개치급여DSA적문합정도.방법 선택42례림상부의경동맥협착환자행CTA화DSA검사,CTA후처리채용다유용적재현(volume rendering,VR)화최대강도투영(maximum intensity projection,MIP)기술,대혈관협착정도진행분석.결과 CTA검사여DSA검사비교,경동맥Ⅰ도협착적검출솔간차이유통계학의의(χ2=4.71,P＜0.05),Ⅱ～Ⅳ도협착적검출솔간차이무통계학의의(P＞0.05);CTA진단경동맥Ⅰ도협착적민감도(Se)69.2%、특이도(Sp)95.3%、부합솔(π)85.5%、오진솔(α)4.7%、루진솔(β)30.1%;Ⅱ도협착적Se 82.1%、Sp 97.6%、π 91.3%、α 2.4%、β 17.9%;Ⅲ급Ⅳ도협착적Se 93.3%、Sp 98.1%、π 97.1%、α 1.9%、β 6.7%.결론 경부혈관CTA검사유교고적령민도화특이도,여DSA검사문합정도호,시일충유효、안전、무창적검사수단,치득림상추엄응용.
Objective Digital subtraction angiography (DSA) is the gold criterion for the diagnosis of carotid artery stenosis,the purpose of this study is to assess the diagnostic value of the multilayer spire CT angiography (CTA) for carotid artery stenosis and its coincidence with DSA.Methods Totally 42 patients who were clinically suspected of having carotid artery stenosis (CAS) were examined by CTA and DSA,for CTA post treatment,volume rendering and maximum intensity projection technology was adopted.The degree of vascular stenosis was analyzed.Results The detection rate of grade Ⅰ carotid stenoses by CTA was significantly different from that by DSA (χ2=4.71,P＜0.05),but those of grade Ⅱ-Ⅳ carotid stenoses were not (P＞0.05).In the diagnosis of grade Ⅰ carotid stenosis by CTA the sensitivity (Se) was 69.2%,specificity (Sp) was 95.3%,total consistent rate (π) was 85.5%,misdiagnostic rate (α) was 4.7%,and omission diagnostic rate (β) was 30.1%.In the diagnosis of grade Ⅱ carotid stenoses by CTA,the Se was 82.1%,Sp was 97.6%,π was 91.3%,α was 2.4%,and β was 17.9%.In the diagnosis of grade Ⅲ-Ⅳ carotid stenoses by CTA,Se was 93.3%,Sp was 98.1%,π was 97.1%,α was 1.9%,and β was 6.7%.Conclusion CTA has higher sensitivity and Specificity for examination of carotid artery,it agrees well with DSA.It is an effective,safe and noninvasive examinational means,worth popularizing and applying in clinic.
