64-多层螺旋CT造影诊断大脑后循环动脉狭窄的临床价值  

Clinical value of 64-multi-layered screw CT angiography for diagnosing arteriostenosis of posterior cerebral circulation

作　　者：钟才[1] 韦英海[1] 吴振宏[1] 欧阳强[1] 蓝玉[1] 

机构地区：[1]广西壮族自治区民族医院神经内科,南宁市530001

出　　处：《广西医学》2016年第5期648-650,共3页Guangxi Medical Journal

摘　　要：目的评价64-多层螺旋CT造影(64-MSCTA)对大脑后循环动脉狭窄的诊断价值。方法缺血性脑血管病患者65例均行64-MSCTA检查,对椎基底动脉成像质量进行评估,诊断为后循环缺血性卒中患者再行数字减影血管造影(DSA)检查,以DSA为金标准,评价64-MSCTA对椎基底动脉狭窄的诊断价值。结果 64-MSCTA检查成像优良率为98.15%。64-MSCTA检查发现椎基底动脉发生不同程度狭窄或闭塞41支,其中轻度狭窄10支,中度狭窄11支,重度狭窄18支,闭塞2支。DSA检查发现椎基底动脉发生不同程度狭窄或闭塞40支,其中轻度狭窄12支,中度狭窄10支,重度狭窄16支,闭塞2支。64-MSCTA对各级狭窄诊断的灵敏性、特异性、阳性预测率和阴性预测率为:轻度狭窄分别为75.00%、98.48%、90.00%、95.59%;中度狭窄分别为80.00%、95.59%、72.73%、97.01%;重度狭窄分别为100.00%、96.77%、88.89%、100.00%;闭塞均为100.00%。结论 64-MSCTA诊断大脑后循环动脉狭窄有一定的临床价值。Objective To evaluate the clinical value of 64-multi-layered screw CT angiography（ 64-MSCTA） for diagnosing arteriostenosis of posterior cerebral circulation. Methods Sixty-five patients with ischemic cerebrovascular disease underwent 64-MSCTA examination,and the imaging quality of vertebrobasilar artery was assessed. Then the patients diagnosed as posterior circulation ischemic stroke underwent digital subtraction angiography（ DSA）. The diagnostic value of 64-MSCTA for vertebrobasilar artery stenosis was evaluated using DSA as the gold standard. Results The imaging excellent rate of 64-MSCTA was 98. 15%. The results of 64-MSCTA showed that stenosis with various degrees or occlusion existed in 41 vertebrobasilar arteries,including 10 with mild stenosis,11 with moderate stenosis,18 with severe stenosis and 2 with occlusion. The results of DSA showed that stenosis with various degrees or occlusion existed in 40 vertebrobasilar arteries,including 12 with mild stenosis,10 with moderate stenosis,16 with severe stenosis and 2 with occlusion. The diagnostic sensitivity,specificity,positive predictive value and negative predictive value of 64-MSCTA for mild stenosis were 75. 00%,98. 48%,90. 00% and 95. 59% respectively,for moderate stenosis were80. 00%,95. 59%,72. 23% and 97. 01% respectively,and for severe stenosis were 100. 00%,96. 77%,88. 89% and 100. 00% respectively. All of the diagnostic sensitivity,specificity,positive predictive value and negative predictive value of 64-MSCTA for occlusion were 100. 00%.Conclusion 64-MSCTA is valuable for diagnosing arteriostenosis of posterior cerebral circulation to a certain.

关 键 词：动脉狭窄 后循环缺血卒中 64-多层螺旋CT造影 诊断 

分 类 号：R743.31[医药卫生—神经病学与精神病学]