彩色多普勒超声联合CTA对椎动脉起始段重度狭窄的诊断价值初探  

To explore the value of color Doppler ultrasonography combined with CTA in the diagnosis of severe stenosis of vertebral artery origin segment

作　　者：张晗 郭曼 刘犇[1] ZHANG Han;GUO Man;LIU Ben(Department of Physical Diagnosis,The Affiliated Brain Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029,China)

机构地区：[1]南京医科大学附属脑科医院物理诊断科,江苏南京210029

出　　处：《影像研究与医学应用》2023年第22期14-17,共4页Journal of Imaging Research and Medical Applications

摘　　要：目的:探讨彩色多普勒超声联合CTA对椎动脉起始段重度狭窄的诊断价值。方法:连续性收集2021年1月—2023年7月南京医科大学附属脑科医院收治的160例疑似椎动脉重度狭窄的患者作为研究对象,患者均进行椎动脉彩色多普勒超声(CDUS)、CT血管造影(CTA)检查以及数字减影血管造影(DSA)检查。共计115例阳性患者,其中有5例患者双侧椎动脉重度狭窄。以DSA作为金标准,分别比较CDUS、CTA以及CDUS联合CTA与DSA的诊断符合率及影像率,并进行一致性分析,评价其对椎动脉重度狭窄的诊断价值。结果:CDUS单独检出椎动脉重度狭窄70处,诊断符合率为58.3%;CTA单独检出椎动脉重度狭窄92处,诊断符合率76.7%;CDUS联合CTA检出椎动脉重度狭窄99处,诊断符合率为82.5%,三者之间差异均具有统计学意义(P <0.05);CDUS诊断阳性85例、阴性75例、误诊10例、漏诊40例;CTA诊断阳性98例、阴性62例、误诊7例、漏诊24例;CDUS+CTA诊断阳性107例、阴性53例、误诊4例、漏诊12例;CDUS+CTA联合检查诊断椎动脉起始段重度狭窄准确率、灵敏度、特异度均高于CDUS、CTA单一检查,误诊率、漏诊率均低于CDUS、CTA单一检查,同DSA一致性较好(Kappa值=0.765)。结论:CDUS联合CTA对椎动脉起始段重度狭窄具有较高的诊断价值。Objective To investigate the diagnostic value of color Doppler ultrasonography combined with CTA in the severe stenosis of vertebral artery origin segment.Methods Continuous collection of 160 suspected patients with severe vertebral artery stenosis admitted to the Affiliated Brain Hospital of Nanjing Medical University from January 2021 to July 2023 as research subjects.The patients were examined by color Doppler ultrasonography(CDUS),compared with CT angiography(CTA)and finally diagnosed by digital subtraction angiography(DSA).A total of 115 patients were positive,including 5 patients with severe bilateral vertebral artery stenosis.Using DSA as the gold standard,the diagnostic coincidence rate and image rate of CDUS,CTA,CDUS combined with CTA and DSA were compared,and the consistency was analyzed,and their diagnostic value in severe vertebral artery stenosis was evaluated.Results CDUS alone detected 70 sites of severe vertebral artery stenosis,the diagnostic coincidence rate was 58.3%,92 cases of severe vertebral artery stenosis were detected by CTA alone,and the diagnostic coincidence rate was 76.7%.99 cases of severe vertebral artery stenosis were detected by CDUS combined with CTA,and the diagnostic coincidence rate was 82.5%.The difference among the three was statistically significant(P<0.05).The diagnosis of CDUS was positive in 85 cases,negative in 75 cases,misdiagnosis in 10 cases and missed diagnosis in 40 cases.CTA diagnosis was positive in 98 cases,negative in 62 cases,misdiagnosis in 7 cases,missed diagnosis in 24 cases,CDUS+CTA positive in 107cases,negative in 53 cases,misdiagnosis in 4 cases and missed diagnosis in 12 cases.The accuracy,sensitivity and specificity of combined CDUS+CTA examination in the diagnosis of severe stenosis of vertebral artery were higher than those of CDUS and CTA alone,but the misdiagnosis rate and missed diagnosis rate were lower than those of CDU and CTA alone,and were consistent with DSA(Kappa value=0.765).Conclusion CDU combined with CTA has high diagnostic value in se

关 键 词：彩色多普勒超声 对比CT血管造影 数字减影血管造影 椎动脉起始段重度狭窄 

分 类 号：R445[医药卫生—影像医学与核医学]