多层螺旋CT血管成像、数字减影血管造影对主动脉夹层的诊断价值  

Diagnostic value of multi-slice spiral CT angiography and digital subtraction angiography in aortic dissection

作　　者：黄家欣 杨君 HUANG Jiaxin;YANG Jun(Xi'an Fifth Hospital,Xi'an 710012,China)

机构地区：[1]西安市第五医院,陕西西安710012

出　　处：《临床医学研究与实践》2024年第31期135-138,共4页Clinical Research and Practice

摘　　要：目的分析多层螺旋CT血管成像(MSCTA)、数字减影血管造影(DSA)对主动脉夹层(AD)的诊断价值。方法选取2019年5月至2021年4月我院收治的67例疑似AD患者作为研究对象,均行MSCTA与DSA技术诊断,以术后诊断为金标准,评估两种技术的诊断价值。结果67例患者经过术后诊断证实,有58例确诊为AD。58例患者中,发现内膜瓣58例,受累分支数达到161条,破口数187个。MSCTA、DSA技术对AD患者真假腔的检出率比较,差异无统计学意义(P>0.05);MSCTA技术对AD患者分支受累、破口数、内膜瓣的检出率高于DSA技术(P<0.05)。MSCTA与DSA技术检出AD患者真腔远端直径、左锁骨下动脉(LSA)开口平面胸主动脉最大径、第一破口与LSA距离、第一破口大小比较,差异无统计学意义(P>0.05)。MSCTA与DSA技术对AD的诊断灵敏度、特异度、阳性预测值、阴性预测值比较,差异无统计学意义(P>0.05)。结论MSCTA、AD技术具备较为良好的AD诊断灵敏度、特异度,且对于病灶参数测量基本一致,但MSCTA技术在检测病变受累支数、内膜破口等方面更有优势,可作为首选诊断方法。Objective To analyze the diagnostic value of multi-slice spiral CT angiography(MSCTA)and digital subtraction angiography(DSA)in aortic dissection(AD).Methods A total of 67 patients with suspected AD admitted in our hospital from May 2019 to April 2021 were selected as the research objects.All patients were diagnosed by MSCTA and DSA technology.The postoperative diagnosis was used as the gold standard to evaluate the diagnostic value of the two techniques.Results Sixty-seven patients were confirmed by postoperative diagnosis,and 58 patients were diagnosed with AD.Among the 58 patients,58 cases of intimal flap were found,the number of involved branches reached 161,and the number of breaks was 187.There was no significant difference in the detection rate of true and false lumen between MSCTA and DSA technology in AD patients(P>0.05);the detection rate of branch involvement,number of breaks and intimal flap in AD patients by MSCTA technology were higher than those by DSA technology(P<0.05).There were no significant differences between MSCTA and DSA technology in detecting the distal diameter of the true lumen,the maximum diameter of the thoracic aorta at the level of the left subclavian artery(LSA),the distance between the first break and LSA,and the size of the first break in AD patients(P>0.05).There were no significant differences in the sensitivity,specificity,positive predictive value and negative predictive value of MSCTA and DSA technology in the diagnosis of AD(P>0.05).Conclusion MSCTA and AD technology have good diagnostic sensitivity and specificity for AD,and the measurement of lesion parameters is basically the same.However,MSCTA technology has more advantages in detecting the number of diseased vessels and intimal tears,and can be used as the preferred diagnostic method.

关 键 词：主动脉夹层 数字减影血管造影 多层螺旋CT血管成像 

分 类 号：R543.1[医药卫生—心血管疾病]