Application of MSCTA in the Evaluation of Carotid Artery Stenosis Degree before and after Carotid Artery Stenting
Objective To evaluate the application value of multi-slice spiral CT angiography(MSCTA)on the evaluation of carotid artery stenosis degree before and after carotid artery stenting(CAS).Methods The clinical data of 82 patients who underwent CAS in our hospital were retrospectively analyzed from February 2020 to November 2023.All patients underwent MSCTA examination before and after surgery to evaluate the degree of carotid artery stenosis.The changes of carotid artery stenosis degree before and after surgery were compared.The diagnostic value of MSCTA on evaluating carotid artery stenosis degree in patients with different degrees of carotid artery stenosis was evaluated by taking digital subtraction angiography(DSA)as the gold standard.Results Among the 82 patients with carotid artery stenosis,there were 29 cases of left internal carotid artery stenosis,41 cases of right internal carotid artery stenosis and 12 cases of bilateral internal carotid artery stenosis.94 vessels were treated with CAS,and all surgeries were successful.MSCTA results showed that 94 vessels before CAS were mainly moderate and severe,accounting for 82.98％,and some vessels were occluded,accounting for 13.83％.After CAS,patients were mainly mild stenosis(92.55％)and some patients were moderate stenosis(7.45％),and there were no patients with severe stenosis and occlusion.There was a statistically significant difference in the distribution of carotid artery stenosis before and after CAS among 82 patients(P＜0.05).Before CAS,the sensitivities of MSCTA in evaluating mild,moderate and severe carotid artery stenosis and carotid artery occlusion were 0.00％,77.08％,90.62％and 85.71％,the specificities were 96.80％,90.38％,88.701％and 98.75％,the accuracy rates were 96.80％,84.00％,89.36％and 96.80％,and the kappa values with DAS results were 0,0.678,0.770 and 0.870 respectively.After CAS,the sensitivities of MSCTA in assessing mild and moderate carotid artery stenosis and carotid artery occlusion were 92.55％and 0.00％,the specificities were 0.00％and 92.55％,and the accuracy rates were 92.55％and 92.55％,and the kappa values with DAS results were 0 and 0,and the results of MSCTA in evaluating severe carotid artery stenosis and carotid artery occlusion were consistent with the DAS results.Conclusbn MSCTA has good application value on evaluating carotid artery stenosis degree before and after CAS.
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