头颈部CTA和DSA对头颈动脉狭窄诊断比较  

A comparative study of head and neck CTA and DSA in the diagnosis of head and carotid artery stenosis

作　　者：魏书恒[1] 杨雪 车延旭[1] 管琳娜[1] 于淑靖[1] WEI Shuheng;YANG Xue;CHE Yanxu(CT Department,Cangzhou Central Hospital,Hebei,Cangzhou 061001,China)

机构地区：[1]河北省沧州市中心医院CT诊断科,061001

出　　处：《河北医药》2020年第11期1673-1676,共4页Hebei Medical Journal

摘　　要：目的研究头颈部CT血管造影(CTA)和数字减影血管造影(DSA)对头颈动脉狭窄的诊断价值。方法应用东芝320排螺旋CT,对缺血性脑血管病患者80例进行头颈部CTA检查。均以18标准方位、容积再现(VR)、最大密度投影(MIP)及血管分析等方法显示头颈动脉的狭窄、斑块等情况,必要时结合原始图像,通过这些方法综合评价头颈动脉狭窄的原因和程度,并和头颈部DSA检查的结果相对比,以DSA检查结果为金标准,获得头颈部CTA对头颈动脉狭窄诊断的敏感性、特异性。结果CTA与DSA对头颈动脉狭窄诊断结果比较,差异无统计学意义(P>0.05)。头颈部CTA对头颈动脉狭窄诊断的敏感性、特异性分别为92.7%、99.5%。结论自动触发头颈部CTA扫描技术结合头颈动脉18标准方位、VR、MIP及血管分析等方法显示、评价头颈动脉血管狭窄情况的敏感性、特异性均极高,受个体差异影响很小,从而为临床准确诊断和及时治疗提供了有力的依据,对缺血性脑血管病患者减轻症状、缩短病程、改善预后意义重大,从而最大限度的减少缺血性脑血管病的致残甚至致死率,减少对社会劳动力的影响,具有重要的临床意义、经济意义和社会意义。Objective To investigate the diagnostic value of head and neck CT angiography(CTA)and digital subtraction angiography(DSA)for head and carotid artery stenosis.Methods Toshiba 320-slice spiral CT was used to perform the head and neck CTA examination in 80 patients with ischemic cerebrovascular disease(ICD).The head and carotid artery stenosis and plaque were displayed by various methods,including 18 standard orientation,volume rendering(VR),maximal intensity projection(MIP)and vascular analysis,combined with the original images when necessary.The causes and degree of head and carotid artery stenosis were comprehensively evaluated by these methods,and compared with the results of head and neck DSA inspection.With DSA inspection results as the gold standard,the sensitivity and specificity of head and neck CTA for the diagnosis of head and carotid artery stenosis were obtained.Results There were no significant differences in the diagnosis results for head and carotid artery stenosis between CTA and DSA(P>0.05).The sensitivity and specificity of head and neck CTA in diagnosis of head and carotid artery stenosis were 92.7%and 99.5%,respectively.Conclusion The automatic triggering of head and neck CTA scanning technology combined with 18 standard orientations,VR,MIP,and vascular analysis of head and carotid arteries shows that the sensitivity and specificity of head and carotid artery stenosis are extremely high,and are barely affected by individual differences,thereby providing a strong basis for accurate clinical diagnosis and timely treatment,which can obviously improve clinical symptoms,shorten the course of disease,and improve the prognosis of patients with ICD,so as to minimize the disability rate and even lethal rate caused by ICD as well as relieve the impact on the social labor force.Therefore,it is of great clinical,economic and social significance.

关 键 词：头颈部CTA DSA 狭窄 诊断 

分 类 号：R445[医药卫生—影像医学与核医学]