CAJ | 학술논문

目的：探讨64层螺旋CT血管成像在诊断椎基底动脉供血不足中的应用价值。方法693例临床诊断或拟诊为椎基底动脉供血不足的患者行头颈部64层螺旋CT血管成像检查。23例在64层螺旋CT血管成像检查后5～10 d内行（DSA）检查。采用双盲法对所有计数资料采用χ2检验进行统计分析；以DSA为“金标准”，对64层螺旋CT血管成像和DSA发现椎基底动脉狭窄的结果进行统计分析。结果左椎动脉及右椎动脉各段狭窄差别有统计学意义（P＜0.05）。对双侧椎动脉不同性质的斑块在椎动脉各段的分布进行多组频数分布的χ2检验，差别有统计学意义（P＜0.05）。23例患者46条椎动脉既行CTA检查又行DSA检查，以DSA为“金标准”，将检查结果进行对照研究和统计分析，差别无统计学意义（P＝0.774，P＞0.05），同时采用Kappa检验评价CTA对椎基底动脉狭窄的诊断价值（Kappa＝0.803，P＝0.000，P＜0.05，Kappa＞0.75），CTA对椎基底动脉狭窄诊断的敏感度81.6%，特异度97.0%，准确度94.2%，阳性预测值86.1%，阴性预测值95.9%。结论64层螺旋CT血管成像能够清晰显示粥样硬化斑块的性质及周围组织的变化情况，对椎基底动脉供血不足的诊断具有较高的应用价值。
목적：탐토64층라선CT혈관성상재진단추기저동맥공혈불족중적응용개치。방법693례림상진단혹의진위추기저동맥공혈불족적환자행두경부64층라선CT혈관성상검사。23례재64층라선CT혈관성상검사후5～10 d내행（DSA）검사。채용쌍맹법대소유계수자료채용χ2검험진행통계분석；이DSA위“금표준”，대64층라선CT혈관성상화DSA발현추기저동맥협착적결과진행통계분석。결과좌추동맥급우추동맥각단협착차별유통계학의의（P＜0.05）。대쌍측추동맥불동성질적반괴재추동맥각단적분포진행다조빈수분포적χ2검험，차별유통계학의의（P＜0.05）。23례환자46조추동맥기행CTA검사우행DSA검사，이DSA위“금표준”，장검사결과진행대조연구화통계분석，차별무통계학의의（P＝0.774，P＞0.05），동시채용Kappa검험평개CTA대추기저동맥협착적진단개치（Kappa＝0.803，P＝0.000，P＜0.05，Kappa＞0.75），CTA대추기저동맥협착진단적민감도81.6%，특이도97.0%，준학도94.2%，양성예측치86.1%，음성예측치95.9%。결론64층라선CT혈관성상능구청석현시죽양경화반괴적성질급주위조직적변화정황，대추기저동맥공혈불족적진단구유교고적응용개치。
Objective To assess the value of 64-slice spiral CT angiography(CTA)in the diagnosis of vertebrobasilar insufficiency.Methods 693 patients with suspected vertebrobasilar insufficiency underwent 64-slice CTA.Digital subtraction angiography(DSA)was also performed on 23 patients within 5 to 10 days of CTA.The CTA was analyzed using DSA as gold standard. Results There was significant difference in the degree of stenosis and distribution of plaques among the segments of right and left vertebral arteries(P<0.05).There was no significant difference(P=0.774)between CTA and DSA in 23 patients with significant concordance rate(Kappa=0.803,P=0).The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of CTA were 81.6%,97.0%,94.2%,86.1%,and 95.9%,respectively.Conclusions 64-slice CTA can clearly display the characteristics of atherosclerotic plaques and lumen stenosis of vertebrobasilar artery.CTA is valuable in the diagnosis of vertebrobasilar insufficiency.