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目的评价双源64层CT血管造影(CTA)对颈内动脉狭窄诊断的精确性。方法对41例(82支颈内动脉)有前循环脑缺血症状的患者,使用双源64层CT机进行扫描,运用多平面重建(MPR)、曲面重建(CPR)、最大密度投影(MIP)和容积显示(VR)技术进行重建,轴位像扩大测量血管直径。参照北美症状性颈动脉内膜切除试验标准进行血管狭窄度分级。以DSA为标准,观察CTA检查的灵敏度、特异度、阳性预测值及阴性预测值。结果82支血管中70支CTA和DSA检查结果一致,占85.4%;较DSA诊断结果,CTA诊断狭窄率偏高为10支,占12.2%,偏低为2支,占2.4%。狭窄率>70%时,CTA的灵敏度为100%,特异度为98.4%,阳性预测值为95%,阴性预测值为100%,与DSA诊断符合率为98.8%;>50%时,CTA的灵敏度为100%,特异度为96.1%,阳性预测值为93.9%,阴性预测值为100%,与DSA诊断符合率为97.6%。CTA与DSA诊断结果呈正相关(r=0.96,P<0.01)。由CTA推算DSA的回归方程为Y(DSA)=0.965X(CTA)-1.305。CTA可清晰地显示58支血管有动脉粥样硬化斑块形成。结论双源64层CTA在诊断颈内动脉狭窄程度上与DSA有很高的相关性,可作为颈部血管狭窄筛选的常规检查方法。
Objective To evaluate the accuracy of dual-source 64-slice CT angiography (CTA) in the diagnosis of internal carotid artery stenosis. Methods 41 patients (82 internal carotid arteries) with anterior circulation ischemic symptoms were scanned with a double-source 64-slice CT scanner using multiplanar reconstruction (MPR), surface reconstruction (CPR), maximum density projection ) And Volume Display (VR) techniques were used to reconstruct axial measurements of vessel diameter. Reference to North American symptomatic carotid endarterectomy test standard vascular stenosis grade. To DSA as the standard, observe CTA examination sensitivity, specificity, positive predictive value and negative predictive value. Results The results of 70 CTA and DSA in 82 blood vessels were consistent, accounting for 85.4%. Compared with DSA, the diagnostic rate of CTA was 10, accounting for 12.2% and 2 as low as 2.4%. The sensitivity of CTA was 100%, the specificity was 98.4%, the positive predictive value was 95% and the negative predictive value was 100% when the stenosis rate was higher than 70%, and the coincidence rate with DSA was 98.8%. When CTA was> 50% The sensitivity was 100%, the specificity was 96.1%, the positive predictive value was 93.9%, the negative predictive value was 100%, and the coincidence rate with DSA was 97.6%. There was a positive correlation between CTA and DSA (r = 0.96, P <0.01). The regression equation for estimating DSA from CTA is Y (DSA) = 0.965X (CTA) -1.305. CTA clearly shows 58 vessels with atherosclerotic plaque formation. Conclusion The dual-source 64-slice CTA has a high correlation with DSA in the diagnosis of stenosis of internal carotid artery and can be used as a routine screening method for stenosis of cervical stenosis.