目的探讨CT血管造影(CTA)、经 颅多普勒超声(TCD)对缺血性脑卒中患者 颈动脉狭窄的诊断价值。方法 收集2016 年4月-2018年4月我院收治的84例经DSA检 查确诊的颈动脉狭窄患者，均行TCD、CTA 检查；应用Pearson相关系数分析TCD、 CTA与DSA检查评估颈动脉狭窄程度的相关 性；以DSA为金标准，分析TCD、CTA检查 对颈动脉狭窄程度≥70%的诊断效能。结 果 TCD、CTA检查颈动脉狭窄程度分别为 (65.32±21.18)%、(63.48±20.89)%， 均与DSA检查结果(63.11±19.62)%呈正相 关(r=0.913、0.986,P<0.05)。CTA诊断缺 血性脑卒中患者颈动脉狭窄程度≥70%的 敏感度、特异度、准确度、阳性预测值、 阴性预测值、Kappa值分别为93.75%、 96.39%、95.24%、95.24%、95.24%、 0.903，均明显高于TCD的81.25%、 84.34%、82.99%、78.79%、85.37%、 0.704，差异均有统计学意义(P<0.05)。 结论 在诊断缺血性脑卒中患者颈动脉狭 窄上，CTA优于TCD，有望成为替代DSA检 查的更好选择。

Objective To explore the diagnostic value of CT angiography (CTA) and transcranial Doppler ultrasound (TCD) for carotid stenosis in patients with ischemic stroke. Methods A total of 84 patients with carotid stenosis diagnosed by DSA in the hospital during the period of April 2016 to April 2018 were selected. All patients underwent TCD and CTA. Pearson correlation coefficient analysis was performed to analyze the correlation among TCD, CTA and DSA in evaluating the degree of carotid stenosis. Take DSA as the golden standard, the diagnostic efficiency of TCD and CTA for carotid artery stenosis exceeding 70% was analyzed. Results The degree of carotid stenosis diagnosed by TCD and CTA was (65.32±21.18)% and (63.48±20.89)% respectively, which was positively correlated with the result of DSA (63.11±19.62)% (r=0.913, 0.986, P<0.05). The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and Kappa value of CTA in the diagnosis of carotid stenosis in patients with ischemic stroke were 93.75%, 96.39%, 95.24%, 95.24 %, 95.24% and 0.903, which were significantly higher than that of TCD(81.25%, 84.34%, 82.99%, 78.79%, 85.37% and 0.704) (P<0.05). Conclusion CTA is superior to TCD in the diagnosis of carotid stenosis in patients with ischemic stroke, and is expected to become an alternative to replace DSA.