电子束CT血管造影、B型超声与DSA诊断颅外颈动脉狭窄的对照研究  

Diagnosis of extracranial carotid artery stenosis: a comparative study of EBCT angiography, B-mode ultrasonography and digital subtraction angiography

作　　者：刘隆熙[1] 唐镇生[2] 江澄川[2] 赵殿辉[3] 

机构地区：[1]青岛大学附属海慈医院神经外科,山东青岛266033 [2]复旦大学附属华山医院神经外科,上海200040 [3]复旦大学附属华山医院放射科,上海200040

出　　处：《中国微侵袭神经外科杂志》2005年第11期486-488,共3页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：国家医学科学攻关项目(96-906-02-25)

摘　　要：目的探讨电子束CT血管造影(EBCTA)和B型超声(BUS)检查诊断颈动脉狭窄闭塞性疾病的准确性。方法对10例(20根)颅外颈动脉进行EBCTA、DSA和BUS对照研究。结果EBCTA与DSA的吻合率达95%,r=0.9935;BUS与DSA的吻合率仅为65%,r=0.8333,P=0.001。针对以70%～99%狭窄度为绝对手术指征,EBCTA的敏感性、特异性、准确性、阳性和阴性预测值均为100%,BU S则分别为33%、94%、85%、50%和89%。结论EBCTA诊断颅外颈动脉疾病有明显的优越性和可行性,且与DSA有互补作用;BUS对斑块溃疡具高度敏感性,但单独使用有漏诊和误诊的可能,需与EBCTA或DSA结合应用。Objective To evaluate the accuracy of electron beam computed tomographic angiography （EBCTA） and B-mode ultrasonography （BUS） for diagnosis of carotid artery bifurcation stenosis. Methods Twenty carotid arteries in 10 patients with 19 carotid stenoses were comparatively studied by digital subtraction angiography （DSA）, EBCTA and BUS. Results Grading of stenoses on EBCTA agreed highly with DSA in 95% of cases （r=0.9935）. The accordance between DSA and BUS only reached 65% of arteries （r=0.8333, P = 0.001）. Taken high-grade stenosis （70%-99%） as an absolute indication for surgery, EBCTA showed 100% in sensitivity, specificity and diagnostic accuracy. BUS was suboptimal with sensitivity of 33%, specificity of 94%, accuracy of 85%, positive predictive value of 50% and negative predictive value of 89%. Conclusions EBCTA is superior to BUS for evaluating carotid stenosis. EBCTA and DSA might play a complimentary role to each other. BUS is superior to EBCTA and DSA in detecting plaque ulceration. But BUS alone could lead to a possibility of misdiagnosis or miss diagnosis and it should be combined with EBCTA or DSA for detecting ulceration.

关 键 词：脑血管障碍 颈动脉狭窄 体层摄影术 X线计算机 血管造影术 数字减影 超声检查 

分 类 号：R445[医药卫生—影像医学与核医学]