摘要
目的 研究颈部彩色多普勒超声 (CDUS)、CT血管造影(CTA)与数字减影血 管造影(DSA)在劲动脉狭窄病变诊断中的 临床价值。方法 收集我院神经内科2016 年1月-2018年1月间收治的60例疑似颈动 脉狭窄病变患者影像学检查资料,探究 CDUS、CTA及DSA在颈动脉狭窄病变中的 应用价值。结果 ①60例患者中有42例行 CDUS与DSA检查、有31例患者行CTA与DSA 检查、有24例行CDUS、CTA及DSA检查。 ②以DSA检查结果为血管狭窄诊断的金标 准,CDUS在颈动脉狭窄诊断中的灵敏度、 特异度及准确度分别为62.50%、72.22%、 66.67%,CTA分别为76.19%、80.00%、 77.42%,CDUS+CTA分别为80.00%、75.00% 与79.17%。③经比较发现,CDUS+CTA不稳 定斑块检出率最高,其次为单纯CDUS、 CTA,DSA斑块检出率最低。结论 DSA依 旧是血管狭窄诊断的金标准,但CTA联合 CDUS在高危人群及心血管疾病患者院外长 期随访中具有优势性,且CDUS联合CTA在 甄别易损斑块中也具有良好的应用价值。
Objective To study the clinical value of color Doppler ultrasound (CDUS), CT angiography (CTA) and digital subtraction angiography (DSA) in the diagnosis of carotid stenosis lesions. Methods The imaging examination data of 60 patients suspected as carotid stenosis lesions who were admitted to our Department of Neurology from January 2016 to January 2018 were collected. The application value of CDUS, CTA and DSA in carotid stenosis lesions was explored. Results Among 60 patients, 42 cases were given CDUS and DSA, and 31 cases were given CTA and DSA, and 24 cases were given CDUS, CTA and DSA. The DSA results were used as the gold standard for the diagnosis of vascular stenosis, and the sensitivity, specificity and accuracy of CDUS in the diagnosis of carotid stenosis were 62.50%, 72.22% and 66.67% respectively, and the three indexes of CTA were 76.19%, 80.00% and 77.42% respectively, and the three indexes of CDUS+CTA were 80.00%, 75.00% and 79.17%respectively. It was found that the detection rate of unstable plaque was the highest by CDUS+CTA, followed by single CDUS and CTA, and the detection rate ofplaques was the lowest by DSA. Conclusion DSA is still the gold standard for the diagnosis of vascular stenosis, but CTA combined with CDUS is superior in longterm out-of-hospitalfollow-up of high-risk population and patients with cardiovascular diseases. CDUS combined with CTA also has good application value in screening vulnerable plaques.
【关键词】CDUS;CTA;DSA;劲动脉狭窄 病变;诊断价值
【中图分类号】R543.4;R445.1;R445.3
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2019.05.011
前言
动脉粥样硬化好发于颈动脉,特别是颈内外动脉分叉处,有研究 表示,20%~50%的缺血性脑卒中由颈部动脉硬化所致,提示颈动脉狭 窄病变与脑卒中间存在密切关联[1]。动脉狭窄程度及动脉斑块性质直 接影响患者病程发展与预后,目前数字减影造影(DSA)是评估血管狭 窄的金标准,但其检查危险性高,费用昂贵,临床应用性不强,颈部 超声多普勒(CDUS)及CT血管造影(CTA)均为无创检查[2]。有研究提示, CDUS及CTA在心血管性疾病中具有良好的应用价值,能准确评估血管狭 窄程度、筛查易损斑块[3]。为研究DSA、CDUS及CTA在颈动脉狭窄病变 中的诊断价值,我院开展如下研究。
中国CT和MRI杂志
第17卷, 第 5 期
2019年05月
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