目的 研究CT血管成像(CTA)、彩 色多普勒超声(CDFI)和数字减影血管造影 (DSA)对颈内动脉狭窄、斑块形态的诊断 结果，以DSA为金标准，分析CTA和CDFI的 诊断准确性。方法 选择我院在2013年1月 至2015年6月收治的经DSA检查确诊的颈 内动脉狭窄患者180例，并先后行CDFI、 CTA检查，比较三种检测方法对颈内动脉 狭窄、斑块形态的诊断结果，以DSA为金 标准，分析CTA和CDFI的诊断准确性。结 果 DSA确诊患者颈内动脉不规则型斑块的 血管条数为180条，规则型斑块的血管条 数为180条，而CTA确诊患者颈内动脉不 规则型斑块的血管条数为179条，规则型 斑块的血管条数为181条，CDFI确诊患者 颈内动脉不规则型斑块的血管条数为191 条，规则型斑块的血管条数为169条。以 DSA为金标准，CTA和CDFI的灵敏度分别为 98.89%、85.56%，特异性分别为99.44%、 79.44%，阳性预测值分别为99.44%、 80.63%，阴性预测值分别为98.90%、 84.62%，准确度分别为99.17%、82.50%。 结论 与CDFI相比，CTA检查对于颈内动脉 狭窄率≥70%、不规则斑块的诊断准确率 更高，与金标准DSA诊断的准确性具有高 度一致性，而且简单易行，在一定情况下 可代替DSA检查，避免其有创性和潜在的 危险性。

Objective To study the diagnosis of carotid artery stenosis and plaque morphology with CT angiography (CTA), color Doppler ultrasound (CDFI) and digital subtraction angiography (DSA), and DSA as the gold standard, the diagnostic accuracy of CDFI and CTA was analyzed. Methods 180 cases of patients with internal carotid artery stenosis were selected who diagnosed by DSA examination in our hospital from January 2013 to June 2015 ,and successively CDFI, CTA inspection, compare three methods of detection for the diagnosis of internal carotid artery stenosis and plaques form as a result, with DSA as the gold standard, analyze the diagnostic accuracy of CTA and of a CDFI. Results DSA diagnosis in patients with internal carotid artery type irregular patches of blood vessels, article 180 shall rule type patches of vascular article 180, article type and irregular CTA diagnosed patients with internal carotid artery plaque blood vessels, article 179 of the rules of type patches of blood vessels, article 181 of a CDFI confirmed type irregular internal carotid artery plaque in patients with vascular article 191, article article rule type plaque blood vessels 169. With DSA as the gold standard, the sensitivity of CTA and of a CDFI respectively 98.89%, 85.56%, specificity of 99.44%, 79.44% respectively, the positive predictive value were 99.44%, 80.63%, negative predictive value were 98.90%, 84.62%, the accuracy of 99.17%, 82.50% respectively. Conclusion Compared with CDFI, CT angiography (CTA) for internal carotid artery stenosis rate is more than or equal to 70%, irregular plaque diagnosis accurate rate is high, and the accuracy of the gold standard of DSA in diagnosis of with high consistency, and is easy to use, in certain circumstances can replace DSA and avoid the invasive and potentially dangerous.