目的探究缺血性脑卒 中(Cerebralischemicstroke， ICS)患者颈动脉粥样硬化 (Carotidatherosclerosis，CAS)斑块的 超声和CT血管造影的影像学表现。方法 选取2016年2月至2018年2月我院神经内科 收治的90例ICS患者CAS斑块的临床资料作 为研究对象，对所有患者进行超声检查和 CT血管造影检查，分析两种检查结果，并 对两种检查结果的相关因素进行单因素分 析、多因素Logistic回归分析。结果 90 例患者中48例患者斑块阳性，42例患者斑 块阴性，超声检查与CT血管造影检查相比 斑块显示阳性预测值95.7%，阴性预测值 93.0%。CT血管造影与超声检查比较阳性 预测值93.8%，阴性预测值95.2%，kappa 值为0.872，调整一致性为0.942，约登指 数为0.871。kappa值>0.75，两种方式一 致性较高。糖尿病、高血脂、年龄三项 危险因素有显著差异(P<0.05)。多因素 Logistic回归分析结果，高血脂为ICS患 者出现CAS斑块的独立危险因素。结论 对 于ICS患者超声检查颈动脉粥样斑块效果 与CT血管造影结果基本一致，筛查效果准 确性均较高

Objective To investigate the imaging features of ultrasonography and CT angiography for carotid atherosclerosis (CAS) plaque in patients with ischemic cerebral stroke (ICS). Methods The imaging features of ultrasonography and CT angiography for CAS in 90 ICS patients treated in our hospital from Feb 2016 to Feb 2018 were selected and analyzed. Then the univariate analysis and multivariate Logistic regression analysis were carried. Results The CAS plaquewas positive in 48 of the 90 patients and was negative in 42 patients. kappa test showed that the positive predictive value was 95.7% in the ultrasonography examination and 93.8% in the CT angiography, moreover, the negative predictive value was 93.0% in the ultrasonography examination and 95.2% in the CT angiography (kappa=0.872). The consistency of adjustment indices was 0.942, and the Youden index was 0.871 (kappa>0.75). The three risk factors including diabetes mellitus, hyperlipidemia and age were significantly different (P<0.05). Multivariate logistic regression analysis showed that hyperlipidemia was an independent risk factor for CAS plaques in ICS patients. Conclusion The results of ultrasonography and CT angiography for CAS plaques in ICS patients are identical, and the screening results are accurate. Ultrasound examination is a non-invasive examination, which is inexpensive and safe.