螺旋CTA评估脑梗死患者颈部血管狭窄的价值  

Evaluation Value of Spiral CTA in Neck Vascular Stenosis in Patients with Cerebral Infarction

作　　者：潘素芬 潘穗英 余秀奎 谢宇明 PAN Su-fen;PAN Sui-ying;YU Xiu-kui;XIE Yu-ming(Department of Radiology,Liwan Central Hospital Guangzhou,Guangzhou 510175,Guangdong Province,China)

机构地区：[1]广州市荔湾中心医院放射科,广东广州510175

出　　处：《中国CT和MRI杂志》2025年第4期4-6,13,共4页Chinese Journal of CT and MRI

基　　金：广州市荔湾区科技计划项目(20240603);广东省医学科学技术研究基金项目(C2020095)。

摘　　要：目的探析螺旋CT血管成像(MSCTA)在脑梗死(CI)患者颈部血管狭窄评估中的应用价值。方法对2022年3月至2024年9月我院收治的80例CI患者的临床资料进行回顾性分析,所有患者均行MSCTA、数字减影血管造影术(DSA)检查,以DSA诊断结果为“金标准”,分析MSCTA对颈部血管狭窄的诊断价值。结果80例CI患者共对192条颈部血管进行DSA检查,结果示检出无血管狭窄64条(33.33%),计为阴性;颈部血管狭窄128条(66.67%),计为阳性,其中轻度狭窄36条(18.75%),中度狭窄48条(25.00%),重度狭窄30条(15.63%),完全闭塞14条(7.29%)。据此分为轻度狭窄组(n=36)、中度狭窄组(n=48)及重度狭窄组(n=44),不同狭窄程度组MSCTA参数颈内外动脉直径、脑血流量、脑血容量、表面通透性比较,差异均有统计学意义(P<0.05),且重度狭窄组均低于轻、中度狭窄组(P<0.05);Spearman检验结果显示,CI患者颈部血管狭窄程度与上述MSCTA参数均呈负相关性(r=-0.451、-0.435、-0.669、-0.657、-0.596,P<0.05)。MSCTA检出阴性68条(35.42%),阳性124条(64.58%),其中轻度狭窄34条(17.71),中度狭窄47条(24.48%),重度狭窄29条(15.10%),完全闭塞14条(7.29%),其诊断颈部血管狭窄程度的Kappa值、灵敏度、特异度、准确率、阳性预测值、阴性预测值分别为0.815、92.19%、90.63%、91.67%、95.16%、85.29%。结论MSCTA对于CI患者颈部血管狭窄程度的诊断效能较高,还可通过相关参数的定量分析为颈部血管狭窄程度的诊断提供更加丰富的依据。Objective To explore the evaluation value of multislice spiral CT angiography(MSCTA)in neck vascular stenosis in patients with cerebral infarction(CI).Methods A retrospective analysis was performed on the clinical data of 80 patients with CI in the hospital between March 2022 and September 2024,and all patients underwent MSCTA and digital subtraction angiography(DSA).Taking DSA results as the golden standard,diagnostic value of MSCTA in neck vascular stenosis was analyzed.Results In the 192 neck vessels from 80 patients with CI,DSA showed that there were 64 vessels(33.33%)without stenosis(negative)and 128 vessels(66.67%)with stenosis(positive),including 36 vessels(18.75%)with mild stenosis,48 vessels(25.00%)with moderate stenosis,30 vessels(15.63%)with severe stenosis and 14 vessels(7.29%)with complete occlusion.According to the above results,there was mild stenosis group(n=36),moderate stenosis group(n=48)and severe stenosis group(n=44).There were significant differences in MSCTA parameters(diameter of internal and external carotid artery,cerebral blood flow,cerebral blood volume,surface permeability)among different stenosis degree groups(P<0.05),and which in severe stenosis groups were lower than those in mild and moderate stenosis groups(P<0.05).The results of Spearman test showed that the severity of neck vascular stenosis was negatively correlated with the above MSCTA parameters(r=-0.451,-0.435,-0.669,-0.657,-0.596,P<0.05).MSCTA showed that there were 68 negative vessels(35.42%)and 124 positive vessels(64.58%),including 34 vessels(17.71%)with mild stenosis,47 vessels(24.48%)with moderate stenosis,29 vessels(15.10%)with severe stenosis and 14 vessels(7.29%)with complete occlusion.Kappa value,sensitivity,specificity,accuracy,positive predictive value and negative predictive value of MSCTA in the diagnosis of neck vascular stenosis were 0.815,92.19%,90.63%,91.67%,95.16%and 85.29%,respectively.Conclusion MSCTA has high diagnostic efficiency for the severity of neck vascular stenosis in patients with CI,and quant

关 键 词：脑梗死 颈部血管狭窄 螺旋CT血管成像 数字减影血管造影术 诊断价值 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学]