CT血管造影对急性缺血性脑卒中患者颈动脉狭窄和斑块的检测价值  

Value of CT Angiography in Detecting Carotid Stenosis and Plaque in Patients with Acute Ischemic Stroke

作　　者：方祖军 Fang Zujun(Department of Neurology,Wannian Peoples Hospital of Jiangxi Province,Shangrao,Jiangxi 335500)

机构地区：[1]江西省万年县人民医院神经内科,江西上饶335500

出　　处：《现代医用影像学》2023年第8期1387-1390,1407,共5页Modern Medical Imageology

摘　　要：目的:探讨CT血管造影(CT angiography,CTA)对急性缺血性脑卒中患者颈动脉狭窄和斑块的检测价值。方法:选取2018年6月至2021年11月上饶市万年县人民医院神经内科收治的82例急性缺血性脑卒中患者,入院后均接受颈部血管超声(Cervical vascular ultrasound,CVUS)和CTA检查,以数字减影血管造影(Digital subtraction angiography,DSA)结果为金标准,比较CVUS、CTA对颈动脉狭窄和斑块的检出情况,并采用Kappa检验法分析不同检测方法结果的一致性。结果:CTA、CVUS对颈动脉狭窄的诊断准确率分别为90.24%(74/82)、78.05%(64/82),二者差异有统计学意义(χ^(2)=4.571,P<0.05)。一致性检验显示,CTA、CVUS与DSA颈动脉狭窄程度诊断结果的Kappa值依次为0.753、0.663。DSA共检出178个斑块,CTA、CVUS的斑块检出率分别为87.64%(156/178)、78.09%(139/178),二者差异有统计学意义(χ^(2)=5.717,P<0.05)。结论:CTA对急性缺血性脑卒中患者颈动脉狭窄和斑块的诊断价值均优于CVUS,可作为临床影像学检查的首选手段。Objective:To investigate the value of CT angiography(CTA)in detecting carotid stenosis and plaque in patients with acute ischemic stroke.Methods:82 patients with acute ischemic stroke treated in the Department of Neurology of Wannian County People's Hospital of Shangrao City from June 2018 to November 2021 After admission,all patients underwent cervical vascular ultrasound(CVUs)and CTA,Taking the results of digital subtraction angiography(DSA)as the gold standard,the detection of carotid stenosis and plaque by CVUs and CTA were recorded respectively,and the consistency of the results of different detection methods was analyzed by kappa test.Results:According to the results of DSA,the accuracy of CTA and CVUs in the diagnosis of carotid stenosis was 90.24%(74/82)and 78.05%(64/82),respectively.There was significant difference between them(χ^(2)=4.571,P<0.05).The consistency test showed that the kappa values of CTA,CVUs and DSA were 0.753 and 0.663 respectively.A total of 178 plaques were detected by DSA.The plaque detection rates of CTA and CVUs were 87.64%(156/178)and 78.09%(139/178),respectively.There was significant difference between them(χ^(2)=5.717,P<0.05).Conclusion:CTA is superior to CVUs in the diagnosis of carotid stenosis and plaque in patients with acute ischemic stroke,and can be used as the first choice of clinical imaging examination.

关 键 词：急性缺血性脑卒中 CT血管造影 颈部血管超声 颈动脉狭窄 斑块 一致性 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R816.1[医药卫生—临床医学]