摘要
目的评价双源64层CT血管造影(CTA)对颈内动脉狭窄诊断的精确性。方法对41例(82支颈内动脉)有前循环脑缺血症状的患者,使用双源64层CT机进行扫描,运用多平面重建(MPR)、曲面重建(CPR)、最大密度投影(MIP)和容积显示(VR)技术进行重建,轴位像扩大测量血管直径。参照北美症状性颈动脉内膜切除试验标准进行血管狭窄度分级。以DSA为标准,观察CTA检查的灵敏度、特异度、阳性预测值及阴性预测值。结果82支血管中70支CTA和DSA检查结果一致,占85.4%;较DSA诊断结果,CTA诊断狭窄率偏高为10支,占12.2%,偏低为2支,占2.4%。狭窄率>70%时,CTA的灵敏度为100%,特异度为98.4%,阳性预测值为95%,阴性预测值为100%,与DSA诊断符合率为98.8%;>50%时,CTA的灵敏度为100%,特异度为96.1%,阳性预测值为93.9%,阴性预测值为100%,与DSA诊断符合率为97.6%。CTA与DSA诊断结果呈正相关(r=0.96,P<0.01)。由CTA推算DSA的回归方程为Y(DSA)=0.965X(CTA)-1.305。CTA可清晰地显示58支血管有动脉粥样硬化斑块形成。结论双源64层CTA在诊断颈内动脉狭窄程度上与DSA有很高的相关性,可作为颈部血管狭窄筛选的常规检查方法。
Objective To evaluate the accuracy of dual source 64-slice CT angiography （CTA） in the diagnosis of internal carotid stenosis. Methods Forty-one patients （82 internal carotid arteries） with cerebral ischemia of the anterior circulation were scanned with dual source 64-slice CTA, and revascularization and axial image for measuring vessel diameter were performed with muhiplanar reconstruction （ MPR）, curved planar reformation （CPR）, maximum intensity projection （MIP） and volume render （VR）. The classification of stenotic degree was performed by using North American symptomatic carotid endarterectomy trial （NASCET）. DSA was used as a standard of examination result to observe the sensitivity, speciality, positive predictive value and negative predictive value of CTA examination. Results The examination results of CTA in 70 of the 82 arteries （ 85.4% ） were in accordance with DSA. The stenosis rate diagnosed by CTA was slightly higher in 10 （ 12.2% ） arteries as compared with the diagnostic results of DSA, and it was slightly lower in 2 （2.4%）. When the stenosis exceeded 70% , the sensitivity, specificity, positive predicting value and negative predictive value of CTA were 100%, 98.4% , 95% and 100%, respectively; when the stenosis exceeded 50%, the sensitivity, specificity, positive predicting value and negative predictive value of CTA were 100%, 96.1% , 93.9% and 100%, respectively. The diagnostic results of CTA were positively correlated with those of DSA （ r = 0.96, P 〈 0. 01 ）. Calculating the regression equation of DSA from CTA is Y（DSA） = 0. 965X （CTA） - 1. 305. Conclusion CTA has very high correlation with DSA in diagnosing the degree of carotid stenosis, and can be used as a routine examination of carotid stenosis screening.
出处
《中国脑血管病杂志》
CAS
2007年第12期547-550,559,共5页
Chinese Journal of Cerebrovascular Diseases
作者简介
胡伟现为南方医科大学2006级硕士研究生
通讯作者：刘新峰，Email：xfliu2@yahoo．com．cn
