CVUS与CTA在脑卒中患者颈动脉狭窄中的检出灵敏性与准确率分析
Sensitivity and accuracy analysis of CVUS and CTA in detecting carotid artery stenosis in stroke patients
李红琴 1韩琼 1岳琳坤1
作者信息
- 1. 运城市中心医院超声科 山西 运城 044000
- 折叠
摘要
目的 探讨颈部血管超声(CVUS)与CT血管造影(CTA)在脑卒中患者颈动脉狭窄中的检出灵敏性与准确率.方法 回顾性选择2020年1月至2023年12月在运城市中心医院超声科接受影像学检查的108例脑卒中患者作为研究对象,入院后均接受CVUS和CTA检查.将数字减影血管造影(DSA)检查作为金标准,比较CVUS、CTA的颈动脉狭窄检出结果,及对狭窄程度的诊断效能.结果 108例患者的DSA检出结果,颈动脉狭窄轻度28例(25.93％),中度63例(58.33％),重度13例(12.04％),闭塞4例(3.70％).CVUS的准确性、灵敏性、特异性、阳性预测值、阴性预测值与CTA相比,差异均无统计学意义(P＞0.05);CVUS、CTA和CVUS联合CTA的特异性对比,差异均无统计学意义(P＞0.05);CVUS联合CTA的准确性、灵敏性、阳性预测值、阴性预测值高于CVUS、CTA,差异均有统计学意义(P＜0.05).CVUS与DSA诊断结果的一致性较好(Kappa=0.823,P＜0.05);CTA与DSA诊断结果的一致性较好(Kappa=0.829,P＜0.05).CVUS和CTA在颈动脉左侧狭窄、右侧狭窄、双侧狭窄中的诊断对比,差异均无统计学意义(P＞0.05);CVUS联合CTA在颈动脉左侧狭窄、右侧狭窄、双侧狭窄中的检出率高于CVUS、CTA,差异均有统计学意义(P＜0.05).结论 CVUS和CTA在脑卒中颈动脉狭窄诊断中均能达到较理想的检出效果,适当考虑联用两种检查方式,能进一步提高检出结果的准确性、灵敏性、阳性预测值、阴性预测值,临床检查中需根据患者的具体情况选择最适宜的检查方式.
Abstract
Objective To investigate the sensitivity and accuracy of cervical vascular ultrasound(CVUS)and CT angiography(CTA)in the detection of carotid artery stenosis in stroke patients.Methods A total of 108 stroke patients who received imaging examination in the Depart-ment of Ultrasonography,Yuncheng Central Hospital from January 2020 to December 2023 were retrospectively selected as the study objects,and all of them received CVUS and CTA examination after admission.Digital subtraction angiography(DSA)was used as the gold standard to compare the results of carotid artery stenosis in CVUS group and CTA group,and the diagnostic efficiency of stenosis degree.Results DSA detection re-sults of 108 patients showed that 28 cases(25.93％)had mild carotid artery stenosis,63 cases(58.33％)had moderate carotid artery stenosis,13 cases(12.04％)had severe carotid artery stenosis,and 4 cases(3.70％)had occlusion.There were no statistically significant differences in accuracy,sensitivity,specificity,positive predictive value and negative predictive value between CVUS and CTA(P＞0.05).There was no sta-tistically significant difference in the specificity of CVUS,CTA and CVUS combined with CTA(P＞0.05).The accuracy,sensitivity,positive predictive value and negative predictive value of CVUS combined with CTA were higher than those of CVUS and CTA,the differences were statisti-cally significant(P＜0.05).There was good consistency between CVUS and DSA(Kappa=0.823,P＜0.05).There was good consistency be-tween CTA and DSA(Kappa=0.829,P＜0.05).There were no statistically significant differences in the diagnosis of left,right and bilateral ca-rotid stenosis between CVUS and CTA(P＞0.05).The detection rate of CVUS combined with CTA in left,right and bilateral carotid stenosis was higher than those in CVUS and CTA,the differences were statistically significant(P＜0.05).Conclusion Both CVUS and CTA can a-chieve ideal detection results in the diagnosis of carotid artery stenosis in stroke.Appropriate consideration of the combination of the two examina-tion methods can further improve the accuracy,sensitivity,positive predictive value and negative predictive value of the detection results.The most appropriate examination method should be selected according to the specific conditions of patients in clinical examination.
关键词
脑卒中/颈动脉狭窄/颈部血管超声/CT血管造影Key words
Stroke/Carotid artery stenosis/Cervical vascular ultrasound/CT angiography引用本文复制引用
出版年
2024
NETL
NSTL
万方数据