多层螺旋CT血管成像在后循环缺血诊断中的应用价值  

The application value of multi-slice CT angiography in the diagnosis for posterior circulation ischemia

作　　者：宋利宏[1] 贾梅霞[1] 吕慧霞[1] 尹继磊[1] 刘云[1] 夏远舰[1] 

机构地区：[1]河北省邯郸市中心医院,056001

出　　处：《河北医药》2012年第19期2885-2888,共4页Hebei Medical Journal

摘　　要：目的探讨多层螺旋CT血管成像(MSCTA)在后循环缺血诊断中的应用价值。方法对90例后循环缺血患者在MRA诊断后7d内行头颈部MSCTA检查,2周内同时行数字减影血管造影(DSA)检查。结果以DSA为金标准,90例MSCTA诊断椎基底动脉狭窄总的敏感性为100%,特异性为96.67%,符合率为95%(Kappa值=0.967,P<0.01);MSCTA对有临床意义的椎基底动脉狭窄分级对比,敏感性、特异性、符合率、阳性预测值、阴性预测值,分别为轻度狭窄:100%、97.22%、97.14%、83.33%、100%;中度狭窄:100%、97.22%、97.67%、87.50%、100%;重度狭窄:100%、91.49%、92.85%、69.23%、100%;闭塞:100%、100%、100%、100%、100%。结论 MSCTA对后循环缺血中椎基底动脉狭窄病变的检出具有重要的诊断价值。Objective To investigate the application value of multi-slice CT angiography（MSCTA） in the diagnosis for posterior circulation ischemia. Methods 90 patients with posterior circulation ischemia were examined by MSCTA in head and neck region within 7 days after MRA diagnosis, and the patients were examined by digital subtraction angiography（DSA）. Results DSA as the gold standard, the diagnostic sensitivity of MSCTA in 90 patients with vertebrobasilar artery stenosis was 100%, diagnostic specificity was 96.67% and coincidence rate was 95 %, the Kappa value = O. 967 （ P 〈 O. O1 ）. The sensitivity, specificity, coincidence rate, positive predictive value, negative predictive value in clinically significant vertebrobasilar stenosis grading according to MSCTA examination were as follows ： in the mild stenosis ： 100%, 97.22%, 97.14%, 83.33%, 100% ; moderate stenosis： 100% ,97.22%, 97.67%, 87.50%, 100% ; severe stenosis： 100%, 91.49%, 92. 85 %, 69.23%, 100% ;occlusion：100% ,100% ,100% ,100% ,100% ,respectively. Conclusion MSCTA has an important value in the detection of posterior circulation ischemia in vertebrobasilar stenosis.

关 键 词：体层摄影术 螺旋计算机 后循环缺血 椎动脉 数字减影血管造影 

分 类 号：R743.31[医药卫生—神经病学与精神病学]