2D-DSA与3D-DSA在颈动脉狭窄诊治中的比较  

2D-DSA versus 3D-DSA in diagnosis and treatment of carotid artery stenosis

作　　者：杨书瀚 万圣云[1] 丁洋[1] 孔令尚[1] 叶琨[1] 常聪聪 刘彪 沈奥林 魏凯凯 YANG Shuhan;WAN Shengyun;DING Yang;KONG Lingshang;YE Kun;CHANG Congcong;LIU Biao;SHEN Aolin;WEI Kaikai(Second Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230601,China)

机构地区：[1]安徽医科大学第二附属医院,安徽合肥230601

出　　处：《现代临床医学》2018年第2期93-95,共3页Journal of Modern Clinical Medicine

摘　　要：目的:比较三维数字减影血管造影(3D-DSA)、二维数字减影血管造影(2D-DSA)在颈动脉硬化狭窄诊治中的应用价值。方法:对2014年9月至2017年4月我院血管外科收治经颈动脉彩超或者CTA发现的颈动脉硬化狭窄患者36例,共计72条颈动脉,入院均行常规2D-DSA、3D-DSA检查,比较二者在狭窄程度判断、溃疡斑块的检出、手术适应证评估上的差异。结果:2D-DSA与3D-DSA在颈动脉狭窄程度分级上的诊断价值相当,具有良好的一致性(Kappa=0.697),其中2D-DSA得出的狭窄度平均值(42.59%)稍低于3D-DSA(49.86%);2D-DSA与3D-DSA在颈动脉溃疡斑块检出能力上的差异具有统计学意义(P=0.017);2D-DSA与3D-DSA在颈动脉狭窄手术适应证评估上的差异存在统计学意义(P=0.01),症状组(P=0.031)及无症状组(P=0.035)的差异均有统计学意义。结论:3D-DSA作为2D-DSA进一步的检查方法,在颈动脉狭窄患者手术适应证评估能力上存在更大的优势。Objective:To compare the application value in the diagnosis and treatment of carotid artery stenosis between three-dimensional digital subtraction angiography(3D-DSA)and two-dimensional digital subtraction angiography(2D-DSA).Methods:From September 2014 to April 2017,36 patients(72 carotid arteries)with carotid artery stenosis detected by CTA or color Doppler received 2D-DSA and 3D-DSA examination.The differences in the judgment of stenosis degree,the detection of plaque ulcer,and the evaluation of surgical indications were compared between the two DSAs,Results:The diagnostic value of 2D-DSA and 3D-DSA in the classification of carotid artery stenosis was similar with good consistency(^appa=0.697);the average degree of stenosis detected by 2D-DSA(42.59%)was slightly lower than that by 3D-DSA(49.86%).There was a significant difference in the detection of carotid artery plaque ulcer between 2D-DSA and 3D-DSA(P=0.017);moreover,they demonstrated a significant difference in the evaluation of surgical indications(P=0.01),and the differences in symptomatic group and asymptomatic group were both significant(P=0.031 and P=0.035,respectively).Conclusion:As a further examination of 2DDSA,3D-DSA has a greater advantage in the assessment of surgical indications for patients with carotid artery stenosis.

关 键 词：颈动脉狭窄 三维数字减影血管造影 二维数字减影血管造影 手术适应证 

分 类 号：R543.4[医药卫生—心血管疾病]