CAJ | 학술논문

目的：探讨64排螺旋 CT 血管造影（64-slice CT angiography，64-SCTA）、MR 血管造影（ magnetic resonance angiography，MRA）对椎-基底动脉穿颅底段血管狭窄程度及管壁斑块性质评估的临床应用价值。方法回顾性分析后循环缺血并同期行64-SCTA、MRA、数字减影血管造影（digital subtraction angiography，DSA）检查的50例患者图像。比较64-SCTA、MRA、DSA 3种检测法对评价椎-基底动脉穿颅底段血管狭窄程度构成比的能力；以DSA 检查结果为“金标准”，分别计算64-SCTA 及 MRA 对椎-基底动脉穿颅底段血管狭窄程度诊断的灵敏度、特异度、准确率；测量椎-基底动脉穿颅底段管壁斑块的密度，比较64-SCTA、MRA 及 DSA 发现椎-基底动脉穿颅底段管壁斑块及评估斑块性质的能力。结果64-SCTA、MRA、DSA 3种检测法对评价椎-基底动脉穿颅底段血管狭窄程度构成比的差异无统计学意义；在评价椎-基底动脉穿颅底段狭窄程度方面，64-SCTA、MRA 对 V4和 V5段敏感度、特异度和准确度较高，MRA 对 V2和 V3段敏感度、特异度和准确度最低；64-SCTA、MRA 及 DSA 发现椎-基底动脉穿颅底段血管斑块能力的差异有统计学意义。结论64-SCTA、MRA 对椎-基底动脉 V4和 V5段血管狭窄程度的评估有着较高的诊断价值；64-SCTA 发现椎-基底动脉穿颅底段血管斑块和评估斑块性质能力优于 DSA 和MRA，64-SCTA 对指导临床治疗具有重要意义。
목적：탐토64배라선 CT 혈관조영（64-slice CT angiography，64-SCTA）、MR 혈관조영（ magnetic resonance angiography，MRA）대추-기저동맥천로저단혈관협착정도급관벽반괴성질평고적림상응용개치。방법회고성분석후순배결혈병동기행64-SCTA、MRA、수자감영혈관조영（digital subtraction angiography，DSA）검사적50례환자도상。비교64-SCTA、MRA、DSA 3충검측법대평개추-기저동맥천로저단혈관협착정도구성비적능력；이DSA 검사결과위“금표준”，분별계산64-SCTA 급 MRA 대추-기저동맥천로저단혈관협착정도진단적령민도、특이도、준학솔；측량추-기저동맥천로저단관벽반괴적밀도，비교64-SCTA、MRA 급 DSA 발현추-기저동맥천로저단관벽반괴급평고반괴성질적능력。결과64-SCTA、MRA、DSA 3충검측법대평개추-기저동맥천로저단혈관협착정도구성비적차이무통계학의의；재평개추-기저동맥천로저단협착정도방면，64-SCTA、MRA 대 V4화 V5단민감도、특이도화준학도교고，MRA 대 V2화 V3단민감도、특이도화준학도최저；64-SCTA、MRA 급 DSA 발현추-기저동맥천로저단혈관반괴능력적차이유통계학의의。결론64-SCTA、MRA 대추-기저동맥 V4화 V5단혈관협착정도적평고유착교고적진단개치；64-SCTA 발현추-기저동맥천로저단혈관반괴화평고반괴성질능력우우 DSA 화MRA，64-SCTA 대지도림상치료구유중요의의。
Objective To evaluate the clinical application value of 64-slice CT angiography (64-SCTA),magnetic resonance angiography( MRA ) for the skull basal vertebral artery stenosis compared with digital subtraction angiography(DSA);To explore the value of 64-SCTA,MRA and DSA in detecting the nature of plague of the skull basal segment of vertebral artery. Methods A total of 50 patients diagnosed posterior circulation ischemia underwent 64-SCTA,MRA and DSA in our hospital. Their images were retrospectively analyzed. The constituent ratio of 64-SCTA,MRA and DSA for the skull basal vertebral artery stenosis were calculated. The results of 64-SCTA,MRA and DSA were analyzed statistically. The accuracy,sensitivity and specificity were respectively calculated for 64-SCTA and MRA by the“gold standard”for DSA. The results of 64-SCTA and MRA were analyzed statistically. The density of plague of the skull basal segment of vertebral artery was detected. The results of 64-SCTA,MRA and DSA were analyzed respectively. Results There were significant difference among 64-SCTA,MRA and DSA in diagnosing the constituent ratio of the skull basal vertebral artery stenosis. 64-SCTA,MRA had higher accuracy,sensitivity and specificity in diagnosing the V4 - 5 segment of vertebral artery stenosis. MRA had the lowest accuracy,sensitivity and specificity in diagnosing the V2 - 3 segment of vertebral artery stenosis,and the comparison between 64-SCTA,MRA and DSA in diagnosing plague nature of the skull basal vertebral artery showed significant difference. Conclusion 64-SCTA,MRA in evaluating the V4 - 5 segment of vertebral artery stenosis proved higher diagnostic value;64-SCTA in detecting plague nature of the skull basal vertebral artery has higher accuracy than DSA,especially in MRA,64-SCTA has significance in guiding clinical treatment.