脑动脉狭窄的CTA、DSA对比研究临床意义  

A contrast study of CTA and DSA in cerebral artery stenosis

作　　者：袁波[1,2] 刘运海[1] 谭莉[3] 刘秋庭[3] 

机构地区：[1]中南大学湘雅医院神经内科,湖南410008 [2]湖南省第二人民医院神经内科 [3]湖南省第二人民医院神经内科湖南中医药大学临床医学院

出　　处：《脑与神经疾病杂志》2016年第4期229-232,共4页Journal of Brain and Nervous Diseases

摘　　要：目的以数字减影血管造影(DSA)为参照,比较电子计算机断层扫描血管成像(CTA)诊断脑动脉狭窄的准确性,评价其临床价值。方法对150例1月内进行CTA和DSA检查的可疑脑血管狭窄的患者进行对比,研究CTA对脑动脉狭窄的诊断价值。结果从所研究的总的病变部位来分析:CTA与DSA符合率为98.27%(454/462);CTA阴性而DSA阳性者为1.73%(8/462);CTA阳性而DSA阴性者为1.30%(6/462);以DSA作为"金标准";CTA诊断脑动脉狭窄的敏感性为99.57%(460/462),特异性为98.27%(454/462),假阳性为1.32%(6/454),假阴性为1.76%(8/454)。按不同部位分层分析:颈总动脉、颈内动脉起始段、大脑中动脉M1段、椎动脉开口、椎动脉V1、V2段的敏感性和特异性均为100%;颈内动脉岩段至终末端假阴性为10.26%(8/78),椎动脉V3、V4段和基底动脉假阳性为15.34%(6/39)。结论 CTA在诊断脑动脉狭窄方面的敏感性、特异性均很高,可以作为脑血管病的重要诊断和筛查方法。但对颈内动脉岩段至终末端和椎动脉V3、V4段还存在一定的漏诊和误诊率,对于在脑血管病的诊断和治疗方案的决定中还要结合DSA进行全面评价。Objective To explore the application of computed tomography angiography （CTA） in the diagnosis of cerebral artery stenosis and its accuracy comparing with digital substraction angiography（DSA）. Methods 150 patients with CTA and DSA , compare the 2 methods, study the accuracy of CTA in the diagnosis of cerebral artery stenosis. Results Coincidence of CTA is 98.27% （ 454/462）, CTA negative and DSA positive numbered 1.73% （8/462）, CTA positive and DSA negative numbered 1.30% （6/462）, Sensitivity of CTA in the diagnosis of cerebral artery stenosis is 1.76% （8/454） , Specificity is 98.27% （454/462） , false positive is1.32% （ 6/454 ） , false negative is 1.7%（8/462）. When analyze according to different locations, the sensitivity and specificity of common carotid artery, initial segment of internal carotid artery , M1 segment of middle cerebral artery, the ostium, V1 and V2 segments of vertebral artery are 100%. false negative of the petrosa segment to the terminal segment of internal carotid artery is 10.26%（8/78） ,false positive of V3 and V4 segments of vertebral artery and basilar artery is 15.34% （6/39）. Conclusion CTA shows high sensitivity and specificity in the diagnosis of cerebral artery stenosis, it can be used as an important diagnostic and screening method of cerebral vessel disease. But there is false positive and false negative in V3 and V4 segments of vertebral artery and the petrosa segment to the terminal segment of internal carotid artery, it must be associated with DSA in the management of cerebral vessel disease.

关 键 词：电子计算机断层扫描血管成像 数字减影血管造影 脑动脉狭窄 

分 类 号：R734.32[医药卫生—肿瘤]