颈部彩超、CT血管成像和DSA对颈部血管的诊断效果研究
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摘要
目的研究CT血管成像(CTA)、彩色多普勒超声(CDFI)和数字减影血管造影(DSA)对颈内动脉狭窄、斑块形态的诊断结果,以DSA为金标准,分析CTA和CDFI的诊断准确性。方法选择我院在2013年1月至2015年6月收治的经DSA检查确诊的颈内动脉狭窄患者180例,并先后行CDFI、CTA检查,比较三种检测方法对颈内动脉狭窄、斑块形态的诊断结果,以DSA为金标准,分析CTA和CDFI的诊断准确性。结果DSA确诊患者颈内动脉不规则型斑块的血管条数为180条,规则型斑块的血管条数为180条,而CTA确诊患者颈内动脉不规则型斑块的血管条数为179条,规则型斑块的血管条数为181条,CDFI确诊患者颈内动脉不规则型斑块的血管条数为191条,规则型斑块的血管条数为169条。以DSA为金标准,CTA和CDFI的灵敏度分别为98.89%、85.56%,特异性分别为99.44%、79.44%,阳性预测值分别为99.44%、80.63%,阴性预测值分别为98.90%、84.62%,准确度分别为99.17%、82.50%。结论与CDFI相比,CTA检查对于颈内动脉狭窄率≥70%、不规则斑块的诊断准确率更高,与金标准DSA诊断的准确性具有高度一致性,而且简单易行,在一定情况下可代替DSA检查,避免其有创性和潜在的危险性。
Objective To study the diagnosis of carotid artery stenosis and plaque morphology with CT angiography(CTA), color Doppler ultrasound(CDFI) and digital subtraction angiography(DSA), and DSA as the gold standard, the diagnostic accuracy of CDFI and CTA was analyzed. Methods 180 cases of patients with internal carotid artery stenosis were selected who diagnosed by DSA examination in our hospital from January 2013 to June 2015,and successively CDFI, CTA inspection, compare three methods of detection for the diagnosis of internal carotid artery stenosis and plaques form as a result, with DSA as the gold standard, analyze the diagnostic accuracy of CTA and of a CDFI. Results DSA diagnosis in patients with internal carotid artery type irregular patches of blood vessels, article 180 shall rule type patches of vascular article 180, article type and irregular CTA diagnosed patients with internal carotid artery plaque blood vessels, article 179 of the rules of type patches of blood vessels, article 181 of a CDFI confirmed type irregular internal carotid artery plaque in patients with vascular article 191, article article rule type plaque blood vessels 169. With DSA as the gold standard, the sensitivity of CTA and of a CDFI respectively 98.89%, 85.56%, specificity of 99.44%, 79.44% respectively, the positive predictive value were 99.44%, 80.63%, negative predictive value were 98.90%, 84.62%, the accuracy of 99.17%, 82.50% respectively. Conclusion Compared with CDFI, CT angiography(CTA) for internal carotid artery stenosis rate is more than or equal to 70%, irregular plaque diagnosis accurate rate is high, and the accuracy of the gold standard of DSA in diagnosis of with high consistency, and is easy to use, in certain circumstances can replace DSA and avoid the invasive and potentially dangerous.
Objective To study the diagnosis of carotid artery stenosis and plaque morphology with CT angiography(CTA), color Doppler ultrasound(CDFI) and digital subtraction angiography(DSA), and DSA as the gold standard, the diagnostic accuracy of CDFI and CTA was analyzed. Methods 180 cases of patients with internal carotid artery stenosis were selected who diagnosed by DSA examination in our hospital from January 2013 to June 2015,and successively CDFI, CTA inspection, compare three methods of detection for the diagnosis of internal carotid artery stenosis and plaques form as a result, with DSA as the gold standard, analyze the diagnostic accuracy of CTA and of a CDFI. Results DSA diagnosis in patients with internal carotid artery type irregular patches of blood vessels, article 180 shall rule type patches of vascular article 180, article type and irregular CTA diagnosed patients with internal carotid artery plaque blood vessels, article 179 of the rules of type patches of blood vessels, article 181 of a CDFI confirmed type irregular internal carotid artery plaque in patients with vascular article 191, article article rule type plaque blood vessels 169. With DSA as the gold standard, the sensitivity of CTA and of a CDFI respectively 98.89%, 85.56%, specificity of 99.44%, 79.44% respectively, the positive predictive value were 99.44%, 80.63%, negative predictive value were 98.90%, 84.62%, the accuracy of 99.17%, 82.50% respectively. Conclusion Compared with CDFI, CT angiography(CTA) for internal carotid artery stenosis rate is more than or equal to 70%, irregular plaque diagnosis accurate rate is high, and the accuracy of the gold standard of DSA in diagnosis of with high consistency, and is easy to use, in certain circumstances can replace DSA and avoid the invasive and potentially dangerous.
引文
[1]廖文彬.血管CTA成像技术在脑出血早期诊断及其病因判断中的临床应用价值[J].中国CT和MRI杂志,2015,13(9):48-50.
[2]杨浩,邹文英,尹家保,等.颈内动脉超声和DSA对颅外段颈内动脉狭窄诊断的对比研究[J].医学影像学杂志,2010,20(10):1428-1430.
[3]彭涛,李尚喜,刘茂元,等.彩色多普勒超声及血管造影对颈内动脉狭窄或闭塞患者的诊断价值[J].中华医学超声杂志(电子版),2015,12(4):278-282.
[4]初继栋,宋敏.头颈部CTA和颈部血管彩超在脑梗死患者颈内动脉狭窄检测中的应用[J].山东医药,2011,51(15):66-67.
[5]North American Symptomatic Carotid Endarterectomy Trial Collaborators.Beneficial effect of carotidendarterectomy in symptomatic patients with high grade carotid stenosis[J].NEngl J Med,1991,325(7):445-453.
[6]涂富莲.瑞舒伐他汀药物对颈动脉粥样硬化患者血气指标与颈动脉斑块的影响研究[J].中国CT和MRI杂志,2015,13(8):20-22.
[7]崔青,赵立华,王振海.颈部血管超声与DSA对颈内动脉狭窄病变检测的对比分析[J].宁夏医科犬学学报,2013,35(7):801-803.
[8]陈志军,梁立华.颅颈内动脉狭窄的CTA与DSA对照研究[J].中国中西医结合影像学杂志,2015,13(4):399-402.
[9]吕康,刘斌,刘玉玲,等.CT血管成像与血管彩色多普勒超声检查对急性脑梗死患者颈内动脉颅外段病变诊断价值比较[J].中国医药,2014,9(9):1306-1308.
[10]张圆圆,孟秀君,田沈,等.颈部彩色多普勒超声、CT血管成像与数字减影血管造影诊断颈内动脉狭窄、斑块形态及溃疡的准确性比较[J].中国全科医学,2015,18(30):3763-3768.
[2]杨浩,邹文英,尹家保,等.颈内动脉超声和DSA对颅外段颈内动脉狭窄诊断的对比研究[J].医学影像学杂志,2010,20(10):1428-1430.
[3]彭涛,李尚喜,刘茂元,等.彩色多普勒超声及血管造影对颈内动脉狭窄或闭塞患者的诊断价值[J].中华医学超声杂志(电子版),2015,12(4):278-282.
[4]初继栋,宋敏.头颈部CTA和颈部血管彩超在脑梗死患者颈内动脉狭窄检测中的应用[J].山东医药,2011,51(15):66-67.
[5]North American Symptomatic Carotid Endarterectomy Trial Collaborators.Beneficial effect of carotidendarterectomy in symptomatic patients with high grade carotid stenosis[J].NEngl J Med,1991,325(7):445-453.
[6]涂富莲.瑞舒伐他汀药物对颈动脉粥样硬化患者血气指标与颈动脉斑块的影响研究[J].中国CT和MRI杂志,2015,13(8):20-22.
[7]崔青,赵立华,王振海.颈部血管超声与DSA对颈内动脉狭窄病变检测的对比分析[J].宁夏医科犬学学报,2013,35(7):801-803.
[8]陈志军,梁立华.颅颈内动脉狭窄的CTA与DSA对照研究[J].中国中西医结合影像学杂志,2015,13(4):399-402.
[9]吕康,刘斌,刘玉玲,等.CT血管成像与血管彩色多普勒超声检查对急性脑梗死患者颈内动脉颅外段病变诊断价值比较[J].中国医药,2014,9(9):1306-1308.
[10]张圆圆,孟秀君,田沈,等.颈部彩色多普勒超声、CT血管成像与数字减影血管造影诊断颈内动脉狭窄、斑块形态及溃疡的准确性比较[J].中国全科医学,2015,18(30):3763-3768.