缺血性脑卒中患者颈动脉粥样硬化斑块的超声检查与CT血管造影的影像表现分析  

Imaging Features of Ultrasonography and CT Angiography for Carotid Atherosclerosis Plaquein Patients with Ischemic Cerebral Stroke

作　　者：钟跃[1] 邱伟[1] 廖珍兰 张灌生[1] 王娟 ZHONG Yue;QIU Wei;LIAO Zhen-lan(Department of Ultrasonography,First People＇s Hospital of Neijiang City,Neijang 641000,Sichuan Province,China)

机构地区：[1]四川省内江市第一人民医院超声科,四川内江641000

出　　处：《中国CT和MRI杂志》2018年第9期69-72,154,共5页Chinese Journal of CT and MRI

摘　　要：目的探究缺血性脑卒中(Cerebralischemicstroke,ICS)患者颈动脉粥样硬化(Carotidatherosclerosis,CAS)斑块的超声和CT血管造影的影像学表现。方法选取2016年2月至2018年2月我院神经内科收治的90例ICS患者CAS斑块的临床资料作为研究对象,对所有患者进行超声检查和CT血管造影检查,分析两种检查结果,并对两种检查结果的相关因素进行单因素分析、多因素Logistic回归分析。结果 90例患者中48例患者斑块阳性,42例患者斑块阴性,超声检查与CT血管造影检查相比斑块显示阳性预测值95.7%,阴性预测值93.0%。CT血管造影与超声检查比较阳性预测值93.8%,阴性预测值95.2%,kappa值为0.872,调整一致性为0.942,约登指数为0.871。kappa值>0.75,两种方式一致性较高。糖尿病、高血脂、年龄三项危险因素有显著差异(P<0.05)。多因素Logistic回归分析结果,高血脂为ICS患者出现CAS斑块的独立危险因素。结论对于ICS患者超声检查颈动脉粥样斑块效果与CT血管造影结果基本一致。Objective To investigate the imaging features of ultrasonography and CT angiography for carotid atherosclerosis （CAS） plaque in patients with ischemic cerebral stroke （ICS）. Methods The imaging features of ultrasonography and CT angiography for CAS in 90 ICS patients treated in our hospital from Feb 2016 to Feb 2018 were selected and analyzed. Then the univariate analysis and multivariate Logistic regression analysis were carried. Results The CAS plaquewas positive in 48 of the 90 patients and was negative in 42 patients. kappa test showed that the positive predictive value was 95.7% in the ultrasonography examination and 93.8% in the CT angiography, moreover, the negative predictive value was 93.0% in the ultrasonography examination and 95.2% in the CT angiography （kappa=0.872）. The consistency of adjustment indices was 0.942, and the Youden index was 0.871 （kappa〉0.75）. The three risk factors including diabetes mellitus, hyperlipidemia and age were significantly different （P〈0.05）. Multivariate logistic regression analysis showed that hyperlipidemia was an independent risk factor for CAS plaques in ICS patients. Conclusion The results of ultrasonography and CT angiography for CAS plaques in ICS patients are identical, and the screening results are accurate. Ultrasound examination is a non-invasive examination, which is inexpensive and safe.

关 键 词：缺血性脑卒中患者 颈动脉粥样硬化斑块 超声检查 CT血管造影 影像表现 

分 类 号：R743.3[医药卫生—神经病学与精神病学]