当代医学
噹代醫學
당대의학
CHINA CONTEMPORARY MEDICINE
2014年
33期
141-142
,共2页
螺旋CT%血管后处理%模拟手术技术
螺鏇CT%血管後處理%模擬手術技術
라선CT%혈관후처리%모의수술기술
Spiral CT%Vascular treatment after operation%Simulation technology
目的:探讨螺旋CT血管后处理及模拟手术技术的临床应用价值。方法回顾性分析清远市中医院2011年8月~2013年12月确诊为血管狭窄性病变且行经皮腔内血管成形术病例100例,随机均分成A、B 2组(n=50)。A组术前对其进行多层螺旋CT扫描后处理成像及模拟介入治疗,并与DSA(数字减影血管显像技术)诊断结果进行对比;B组直接行DSA造影及介入治疗,比较A、B 2组介入术中选用导管数量、对比剂用量、减影采集序列、透视时间、手术时间。结果与金标准DSA相比较,CTA(计算机断层摄影血管成像技术)的灵敏度为97.4%,特异度为91.4%,正确指数(Youden’sindex)为88.8%;两种诊断方法的一致性Kappa值为0.895(Kappa≥0.75即表示一致性极好),2组差异无统计学意义(P<0.05)。A组术中选用导管数量为(2.0±0.55)支、对比剂用量(35.38±6.5)mL、减影采集序列(3.88±0.56)次、透视时间(10.55±5.57)min、手术时间(30.15±13.25)min等结果明显低于对照组,2组比较差异有统计学意义(P<0.05)。结论多层螺旋CT血管成像后处理及模拟手术技术的临床应用,诊断价值与DSA相当,对术前介入治疗方案的制定、手术材料选择以及其他术前评估、降低术中操作难度及降低手术者及患者辐射剂量有着十分重要的作用。
目的:探討螺鏇CT血管後處理及模擬手術技術的臨床應用價值。方法迴顧性分析清遠市中醫院2011年8月~2013年12月確診為血管狹窄性病變且行經皮腔內血管成形術病例100例,隨機均分成A、B 2組(n=50)。A組術前對其進行多層螺鏇CT掃描後處理成像及模擬介入治療,併與DSA(數字減影血管顯像技術)診斷結果進行對比;B組直接行DSA造影及介入治療,比較A、B 2組介入術中選用導管數量、對比劑用量、減影採集序列、透視時間、手術時間。結果與金標準DSA相比較,CTA(計算機斷層攝影血管成像技術)的靈敏度為97.4%,特異度為91.4%,正確指數(Youden’sindex)為88.8%;兩種診斷方法的一緻性Kappa值為0.895(Kappa≥0.75即錶示一緻性極好),2組差異無統計學意義(P<0.05)。A組術中選用導管數量為(2.0±0.55)支、對比劑用量(35.38±6.5)mL、減影採集序列(3.88±0.56)次、透視時間(10.55±5.57)min、手術時間(30.15±13.25)min等結果明顯低于對照組,2組比較差異有統計學意義(P<0.05)。結論多層螺鏇CT血管成像後處理及模擬手術技術的臨床應用,診斷價值與DSA相噹,對術前介入治療方案的製定、手術材料選擇以及其他術前評估、降低術中操作難度及降低手術者及患者輻射劑量有著十分重要的作用。
목적:탐토라선CT혈관후처리급모의수술기술적림상응용개치。방법회고성분석청원시중의원2011년8월~2013년12월학진위혈관협착성병변차행경피강내혈관성형술병례100례,수궤균분성A、B 2조(n=50)。A조술전대기진행다층라선CT소묘후처리성상급모의개입치료,병여DSA(수자감영혈관현상기술)진단결과진행대비;B조직접행DSA조영급개입치료,비교A、B 2조개입술중선용도관수량、대비제용량、감영채집서렬、투시시간、수술시간。결과여금표준DSA상비교,CTA(계산궤단층섭영혈관성상기술)적령민도위97.4%,특이도위91.4%,정학지수(Youden’sindex)위88.8%;량충진단방법적일치성Kappa치위0.895(Kappa≥0.75즉표시일치성겁호),2조차이무통계학의의(P<0.05)。A조술중선용도관수량위(2.0±0.55)지、대비제용량(35.38±6.5)mL、감영채집서렬(3.88±0.56)차、투시시간(10.55±5.57)min、수술시간(30.15±13.25)min등결과명현저우대조조,2조비교차이유통계학의의(P<0.05)。결론다층라선CT혈관성상후처리급모의수술기술적림상응용,진단개치여DSA상당,대술전개입치료방안적제정、수술재료선택이급기타술전평고、강저술중조작난도급강저수술자급환자복사제량유착십분중요적작용。
Objective To discuss the clinical application value of spiral CT post-processing and simulation techniques. Methods A retrospective analysis of the hospital from August 2011 to December 2013 confirmed the diagnosis of vascular stenosis and percutaneous transluminal angioplasty in 100 cases, were randomly divided into A, B two groups (n=50), A group before the multi-slice spiral CT post-processing imaging and Simulation of interventional therapy, and compared with the DSA results;group B underwent DSA angiography and interventional therapy, comparison of A, B two groups of intervention, the dosage of contrast with vessel number, subtraction acquisition sequence, fluoroscopy time, operation time. Results Compared with the gold standard of DSA, the sensitivity of CTA was 97.4%, the specificity was 91.4%, the correct index (Youden 'sindex) was 88.8%;the consistency of Kappa two diagnostic methods for the value of 0.895 (Kappa≥0.75 indicates an excellent agreement), no statistically significant difference between the two groups (P<0.05). Selection of vessel number, dosage of contrast, subtraction acquisition sequence, fluoroscopy time, operation time had a significant difference between two groups (P<0.05), and group A were less than that in group B. Conclusion Clinical application of processing and simulation operation technique of multi-slice spiral CT angiography findings, diagnostic value and DSA, to formulate operation, material selection of preoperative interventional therapy and other preoperative evaluation, operation difficulty is reduced and the operation an d reduce the patient radiation dose plays a very important role in operation.