CTA与颈部血管彩色超声诊断ACI患者颈动脉颅外段病变的应用研究

［摘要］ 目的探讨CT血管成像（CT angiography，CTA）与颈部血管彩色超声诊断急性脑梗死（acute cerebral infarction，ACI）患者颈动脉颅外段病变的应用价值。 方法回顾性分析100例ACI患者临床资料。患者均接受CTA、颈部血管彩色超声以及数字减影血管造影（digital subtraction angiograph；DSA）检查。比较CTA与颈部血管彩色超声对颈动脉颅外血管狭窄程度、斑块检出情况，以DSA检查结果作为金标准判断2种方式对颈动脉颅外血管狭窄程度的诊断价值。 结果CTA对颈动脉颅外血管狭窄程度检出情况（轻度、中度、重度及闭塞）优于颈部血管彩色超声，但仅在轻度及中度狭窄差异有统计学意义（P＜0.05）；CTA对于颈内动脉内不同类型斑块检出率显著优于颈部血管彩色超声（P＜0.05），而2种方式在颈总动脉以及颈外动脉不同类型斑块检出率差异均无统计学意义（P＞0.05）；以DSA检测结果作为金标准，CTA诊断颈动脉颅外血管狭窄程度的敏感度、特异度、准确度、阳性预测值和阴性预测值均高于颈部血管彩色超声，但仅在敏感度、准确度及阴性预测值差异有统计学意义（P＜0.05）。 结论应用CTA诊断ACI患者动脉颅外段病变时，其效率优于颈部血管彩色超声，尤其是在对血管狭窄程度及颈内动脉斑块类型诊断上优势更为显著。

Application of CTA and cervical vascular color Dopplerultrasound in diagnosis of extracranial lesions of carotid artery in ACI patients

［Abstract］ Objective〖HTSS〗To investigate differences in the application value of CT angiography(CTA) and cervical vascular color Doppler ultrasound in diagnosis of extracranial lesions of carotid artery in patients with acute cerebral infarction(ACI). Methods〖HTSS〗A retrospective analysis was performed on examination data from 100 ACI patients. All patients underwent CTA, cervical vascular color Doppler ultrasound and digital subtraction angiography(DSA). The detection conditions for extracranial vascular stenosis degree of carotid artery and plaquesby CTA and cervical vascular color Doppler ultrasound were compared. Taking DSA results as golden standard,diagnostic value of the two methods for extracranial vascular stenosis degree of carotid artery was judged. Results〖HTSS〗The detection conditions for extracranial vascular stenosis degree of carotid artery(mild, moderate, severe, and embolization) by CTA was much better than those by cervical vascular color Doppler ultrasound. And there were significant differences only in mild and moderate stenosis(P＜0.05). The detection rate of CTA for different types plaques in internal carotid artery was better than that of cervical vascular color Doppler ultrasound(P＜0.05). There was no significant difference in detection of different types plaques between common carotid artery and external carotid artery(P＞0.05). Taking DSA results as golden standard, sensitivity, specificity, accuracy, positive predictive value and negative predictive value of CTA for diagnosis of extracranial vascular stenosis degree of carotid artery were higher than those of cervical vascular color Doppler ultrasound.There were only significant differences in sensitivity, accuracy and negative predictive value between two methods(P＜0.05). Conclusion〖HTSS〗The diagnostic efficiency of CTA is superior to that of cervical vascular color Doppler ultrasound in diagnosis of extracranial lesions of carotid artery in ACI patients.Especially,the advantages are more obvious in terms of the diagnosis of vascular stenosis degree and plaque type of internal carotid artery.