症状性颅内动脉狭窄应用CTA、TCD与DSA的临床价值评估

目的评估在症状性颅内动脉狭窄（ICASS）诊断中常用的CT血管造影术（CTA）、经颅多普勒（TCD）及数字减影血管造影术（DSA）三种检查的临床价值。方法选择我院209例临床拟诊为ICASS且接受CTA、TCD及DSA等三种检查方法的患者，比较三种检查所发现的颅内动脉病变部位及数量的差异。结果确诊为ICASS患者中DSA阳性率为86．1％（93／108），CTA阳性率为70．9％（122／172），TCD阳性率为67．3％（103／153）（P=0．029）。其中DSA共检查416支颅内动脉，阳性率为89．2％（371／416）；CTA共检查562支颅内动脉，阳性率为72．6％（408／562）；TCD共检查539支颅内动脉，阳性率为68．5％（369／539）（P=0．032）。病变部位中颈内动脉系统阳性率DSA为95．4％（209／219）、CTA为69．7％（193／277）、TCD为70．9％（183／258）（P=0．015）；椎基底动脉系统阳性率为DSA82．2％（162／197）、CTA75．4％（215／285）、TCD66．2％（186／281）（P=0．001）。结论CTA、TCD检查方法较DSA检查方法对ICASS诊断阳性率较低。

Diagnostic value of CT angiography,transcranial doppler sonography, digital subtraction angiography in symptomatic intracranial artery stenosis

Objective To evaluate the clinical value of CT angiography（CTA）, transcranial doppler sonography（TCD） and digital subtraction angiography （DSA）in patients with symptomatic intracranial artery stenosis （ICASS）. Methods A total of 209 patients with ICASS in our hospital were collected to retrospective analyses. The differences of lesion＇s site and range in intracerebral arteries were compared between the outcomes by above methods. Results The positive rates of patients with ICASS were 86.1% （93/108） by DSA, 70.9% （122/172） by CTA, 67.3% （103/153）by TCD, re- spectively（P = 0.029）. And the positive rates of intracerebral arteries were 89.2%（371/416） by DSA, 72.6%（408/562） by CTA, 68.5%（369/539） by TCD, respectively （P = 0.032）. The positive rates of intracervical artery system were 95.4% （209/219） by DSA, 69.7%（193/277） by CTA, 70.9% （183/258） by TCD, respectively （P = 0.015）. The posi- tive rates of vertebrobasilar artery system were 82.2% （162/197） by DSA, 75.4% （215/285） by CTA, 66.2% （186/281 ） by TCD, respectively （P = 0.001 ）. Conclusion The positive rates of the ICASS diagnosis by CTA and TCD were lower than by DSA.