河北医学2024,Vol.30Issue(2) :269-273.DOI:10.3969/j.issn.1006-6233.2024.02.018

CTA评估缺血性脑卒中患者脑血管狭窄程度的价值

Value of CTA in Evaluating Cerebrovascular Stenosis in Patients with Ischemic Stroke

吴婧 徐永敢
河北医学2024,Vol.30Issue(2) :269-273.DOI:10.3969/j.issn.1006-6233.2024.02.018

CTA评估缺血性脑卒中患者脑血管狭窄程度的价值

Value of CTA in Evaluating Cerebrovascular Stenosis in Patients with Ischemic Stroke

吴婧 1徐永敢2
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作者信息

  • 1. 江苏省南京市第一医院/南京医科大学附属南京医院医学影像科, 江苏 南京 210001
  • 2. 江苏省南京市雨花医院/ 南京市第一医院雨花分院医学影像科, 江苏 南京 210012
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摘要

目的:观察CT血管成像(CTA)评估缺血性脑卒中(IS)患者脑血管狭窄程度的价值.方法:回顾性分析2020 年1 月至2023 年6 月我院收治的110 例IS 患者的临床资料.所有患者均行常规经颅多普勒超声、CTA检查,以数字减影血管造影(DSA)为金标准,比较多普勒超声、CTA 检查对 IS 患者脑血管狭窄程度的评估价值.结果:110 例IS患者经DSA检查发现脑血管轻度狭窄 24 例,中度狭窄63 例,重度狭窄13 例,闭塞10 例,其中颅外动脉(56.36%)占比多于颅内动脉(43.64%).多普勒超声检查评估 IS 患者脑血管为中度及以上狭窄的敏感性、特异性及准确性分别为 54.17%、77.91%、72.73%;CTA检查为95.83%、88.37%、90.00%.CTA检查评估IS 患者脑血管中度及以上狭窄的敏感性、准确性、阳性预测值、阴性预测值均显著高于多普勒超声检查(P<0.05).CTA 检查与多普勒超声检查评估脑血管中度及以上狭窄的特异性比较,差异无统计学意义(P>0.05).结论:CTA对IS 患者脑血管狭窄程度具有较高的评估价值,敏感性及准确性高于常规多普勒超声检查,能清晰显示患者脑血管病变情况,为临床诊疗提供参考,值得推广.

Abstract

Objective:To observe the value of CT angiography(CTA)in evaluating the degree of cere-brovascular stenosis in patients with ischemic stroke(IS).Methods:The clinical data of 110 patients with IS admitted to the hospital from January 2020 to June 2023 were analyzed retrospectively.All patients were exam-ined with conventional transcranial Doppler ultrasound and CTA.Digital subtraction angiography(DSA)was taken as the golden standard to compare the value of Doppler ultrasound and CTA in evaluating the degree of cerebrovascular stenosis in patients with IS.Results:DSA found 24 cases of mild cerebrovascular stenosis,63 cases of moderate stenosis,13 cases of severe stenosis,and 10 cases of occlusion.Among them,the propor-tion of extracranial arteries(56.36%)is higher than that of intracranial arteries(43.64%).The sensitivity,specificity and accuracy of Doppler ultrasound in evaluating moderate or more severe cerebrovascular stenosis in patients with IS were 54.17%,77.91%and 72.73%.The sensitivity,specificity and accuracy of CTA were 95.83%,88.37%and 90.00%.The sensitivity,accuracy,positive predictive value and negative pre-dictive value of CTA in evaluating moderate or more severe cerebrovascular stenosis in patients with IS were significantly higher than those of Doppler ultrasound(P<0.05).There was no significant difference in speci-ficity between the two methods(P>0.05).Conclusion:CTA is of high value in evaluating the degree of ce-rebrovascular stenosis in patients with IS,and its sensitivity and accuracy are higher than those of conventional Doppler ultrasound.It can clearly show the patients'cerebrovascular lesions,providing reference for clinical diagnosis and treatment.

关键词

CT血管成像/缺血性脑卒中/脑血管狭窄/评估价值/经颅多普勒超声

Key words

CT angiography/Ischemic stroke/Cerebrovascular stenosis/Evaluation value/Transcranial doppler ultrasound

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基金项目

2022年度省老年健康科研项目(LSD2022017)

出版年

2024
河北医学
河北省医学会

河北医学

CSTPCD
影响因子:1.915
ISSN:1006-6233
参考文献量14
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