【摘要】 目的:探讨256排螺旋CT头颈CTA在颈动脉斑块检查中的应用价值。方法:选取60例2019年4月～2020年4月蚌埠市第一人民医院临床收治的缺血性脑血管疾病患者作为研究对象,所有患者均实施颈部血管彩超、256排螺旋CT头颈动脉血管成像(CTA)及数字血管造影(DSA)检查,统计比较两种检查方式的诊断价值。以DSA检查结果为"金标准"计算两种检查方式诊断颈部血管疾病的敏感性、特异性及准确率,采用Kappa检验评价其检查结果的一致性。结果:彩超诊断颈部血管疾病的敏感性、特异性及准确率分别为92.00%、80.00%、90.00%;CTA诊断颈部血管疾病的敏感性、特异性及准确率分别为74.00%、60.00%、71.67%,差异均有统计学意义(P<0.05)。彩超诊断颈部血管疾病结果与DSA诊断结果一致性一般(Kappa=0.422),CTA诊断颈部血管疾病结果与DSA诊断结果一致性较好(Kappa=0.816)。CTA对颈动脉轻微、轻度及中度狭窄的检出率均高于彩超,差异有统计学意义(P<0.05);对重度狭窄及完全闭塞的检出率结果与彩超差异无统计学意义(P>0.05)。CTA与超声诊断纤维斑块及钙化斑块差异均无统计学意义(P>0.05),对于诊断混合斑块及脂质斑块差异均有统计学意义(P<0.05)。结论:头颈部CTA诊断颈部动脉血管管腔狭窄程度、区分斑块性质及诊断效能方面均优于彩超,临床应用价值更高。更多还原

【Abstract】 Objective To investigate the application value of 256 row spiral CT head and neck CTA in carotid plaque examination.Method From April 2019 to April 2020,60 patients with ischemic cerebrovascular disease were selected as the subjects, the cervical vascular color ultrasound, 256-row spiral CT head and neck artery angiography(CTA) and digital angiography(DSA) were performed in all patients.the diagnostic value of the two methods was statistically compared.The sensitivity, specificity and accuracy of the two methods for diagnosing cervical vascular diseases were calculated by using the DSA test as the “gold standard”, and the consistency of the Kappa test was evaluated.Results The sensitivity, specificity and accuracy of color ultrasound in the diagnosis of cervical vascular diseases were 92.00%、80.00% and 90.00% respectively; CTA sensitivity, specificity and accuracy were 74.00%、60.00% and 71.67% respectively, all the differences were statistically significant(P<0.05).The results of color ultrasound diagnosis of cervical vascular disease were consistent with DSA diagnosis(Kappa=0.422),The results of CTA diagnosis of cervical vascular disease were consistent with those of DSA diagnosis(Kappa=0.816).CTA detection rate of mild, mild and moderate stenosis of carotid artery was higher than that of color Doppler ultrasound(P<0.05);Detection rate of severe stenosis and complete occlusion was similar to that of color Doppler ultrasound(P>0.05).There was no significant difference between CTA and ultrasound in the diagnosis of fibrous plaque and calcified plaque(P>0.05),for the diagnosis of mixed plaque and lipid plaque differences were statistically significant(P<0.05).Conclusion Head and neck CTA in the diagnosis of cervical artery stenosis, plaque differentiation and diagnostic efficacy are better than color ultrasound, clinical application value is higher.更多还原