头颈联合64层CT血管成像诊断颅内外动脉狭窄的临床价值  

Clinical Value of 64-Slice Spiral Computed Tomography Angiography Long Coverage in Intracranial and Cervical Arteries in Arterial Stenosis of Ischemic Cerebrovascular Disease

作　　者：陆敬民[1] 钟井松[2] 林千早 赵连东[1] 杨益龙[3] 

机构地区：[1]淮安市第二人民医院神经内科,江苏省淮安市223002 [2]淮安市第二人民医院放射科 [3]淮安市第二人民医院介入科

出　　处：《中国卒中杂志》2011年第11期858-863,共6页Chinese Journal of Stroke

摘　　要：目的探讨头颈联合64层螺旋CT血管成像(64-slice spiral computed tomography angiography,64-SSCTA)诊断颅内外动脉狭窄的临床价值。方法回顾性分析74例临床确诊为短暂性脑缺血发作(transient ischemic attack,TIA)和缺血性卒中惠者行64-SSCTA及数字减影血管造影(digital subtraction angiography,DSA)影像资料。以DSA作为"金标准",计算64-SSCTA显示血管狭窄的敏感性、特异性、准确率;并对比64-SSCTA和DSA显示血管狭窄的符合程度。结果 74例患者共有814支动脉血管接受评价,64-SSCTA显像中诊断为狭窄或闭塞的有117支,其中103支被DSA证实;有697支诊断为正常的血管,其中688支与DSA结果一致。以DSA作为"金标准"计算出64-SSCTA对患者头颈血管病变检出的敏感性、特异性及准确半分别为92.0%、98.0%和97.2%。64-SSCTA与DSA的吻合系数Kappa=0.81,P<0.01。对比分析发现,64-SSCTA和DSA对血管狭窄检出率差异无统计学意义(x^2=0.076,P=0.439)。结论 64-SSCTA对颅内、外动脉血管狭窄诊断具有较高的敏感性、特异性和准确率,可能为颅内、外动脉血管狭窄提供一种常用的、无创的检测手段,并为颅内、外动脉狭窄的临床治疗提供较为详尽、客观、准确的影像依据。Objective To evaluate the clinical application value of 64-slice spiral computed tomography（CT） angiography to intracranial artery stenosis and cervical artery stenosis.Methods The datas of 64-slice spiral computed tomography angiography（64-SSCTA） and digital subtraction angiography（DSA） in seventy-four patients with transient ischemic attack or ischemic were retrospective analyzed and the level of intra or extra-cranial artery stenosis were evaluated. According to ＂gold standard＂ of DSA, the sensibility, specificity and accuracy rating of 64-SSCTA had been calculated respectively; and the identical degree of angiostegnosis detected by DSA and 64-SSCTA was assessed.Results In the 74 patients, 814 intra or extra-cranial arteries had been evaluated. Among the 117 arteries which had stenosis discovered by 64-SSCTA, there were 103 stenosis had been confirmed by DSA. There were 9 artery stenosis confirmed by DSA did not discovered by 64-SSCTA. According to ＂gold standard＂ of DSA, the sensibility, specificity and accuracy rating of 64-SSCTA to the affection were 92.0%, 98.0% and 97.2% respectively. The difference in detection rate between 64-SSCTA and DSA has no significance（ x2=00.076, P=0.439）.Conclusion Sixty-four-slice spiral CT angiography long coverage in intracranial and cervical arteries is a quick and harmless examination. To the patients with ischemic cerebrovascular disease, 64-SSCTA have high sensibility, specificity and accuracy rating in detecting patient＇s vascular lesions.

关 键 词：体层摄影术 螺旋计算机 脑血管造影术 血管造影术 数字减影 颈动脉狭窄 

分 类 号：R743[医药卫生—神经病学与精神病学]