常规CTA联合减影CTA对颈动脉狭窄的诊断价值  

The Diagnostic Value of Conventional CTA and Subtraction CTA on Carotid Artery Stenosis

作　　者：白少君[1] 李利[1] 

机构地区：[1]天门市第一人民医院CT室,湖北天门431700

出　　处：《CT理论与应用研究（中英文）》2015年第3期415-420,共6页Computerized Tomography Theory and Applications

摘　　要：目的:探讨常规CT血管造影(CTA)联合减影CTA(SCTA)对颈动脉狭窄程度的分辨及诊断价值。方法:对45例颈动脉狭窄疑似患者分别进行常规CTA、减影CTA和数字减影血管造影(DSA),采用诊断实验评价方法比较两种CTA法与DSA法检查颈动脉狭窄程度的一致率及其对颈动脉狭窄的诊断价值。结果:常规CTA显示共62条颈动脉狭窄,SCTA显示共80条不同程度的颈动脉狭窄,DSA显示共76条颈动脉狭窄,常规CTA与DSA检出颈动脉狭窄有差异,SCTA与DSA检出颈动脉狭窄无显著差异(P<0.05)。常规CTA诊断颈动脉狭窄的灵敏度为78.9%(60/76),特异度为85.7%(12/14),阳性预测值为96.8%(60/62),阴性预测值为42.9%(6/14);SCTA诊断颈动脉狭窄的敏感度为98.7%(75/76),特异度为64.3%(9/14),阳性预测值为93.7%(75/80),阴性预测值为90.0%(9/10),与CTA比,SCTA对颈动脉狭窄的诊断灵敏度和阴性预测值较高(P<0.05)。结论:在颈动脉狭窄诊断和分级方面,SCTA较常规CTA更能准确反映颈动脉狭窄的程度。Objective： To investigate the value of conventional CT angiography（CTA） and subtraction CTA（SCTA） on the discrimination of degree and diagnosis of carotid artery stenosis. Methods： The conventional CTA, subtraction CTA and digital subtraction angiography（DSA） were used to perform carotid arteriography in 45 cases of suspected patients with carotid artery stenosis. The evaluation method of diagnostic assay was used to compare the concordance rate of the degree of carotid stenosis between the two CTAs and DSA, and their diagnostic value on carotid artery stenosis. Results： Conventional CTA showed 62 carotid stenosis, 80 by SCTA and 76 by DSA. There had no differences between SCTA and DSA detection of carotid stenosis（P 0.05）. The sensitivity, specificity, positive predictive value and negative predictive value of conventional CTA in diagnosis of carotid artery stenosis were 78.9%（60/76）, 85.7%（12/14）, 96.8%（60/62） and 42.9%（6/14）, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of SCTA in diagnosis of carotid artery stenosis were 98.7%（75/76）, 64.3%（9/14）, 93.7%（75/80） and 90.0%（9/10）. Compared with the conventional CTA, the sensitivity in SCTA was higher（P 0.05）. Conclusions： SCTA has a better ability on discrimination of degree of carotid artery stenosis than the conventional CTA.

关 键 词：CT血管造影 减影CT血管造影 颈动脉狭窄 

分 类 号：R543.4[医药卫生—心血管疾病] R816.2[医药卫生—内科学]