数字减影CT血管成像与彩色多普勒超声对颈动脉粥样硬化斑块检出率及斑块性质、狭窄程度判定的效果比较

目的比较数字减影CT血管成像（DSCTA）与彩色多普勒超声（CDUS）对颈动脉粥样硬化斑块的检出、斑块性质及狭窄程度判定的价值以及一致性。方法回顾性分析2015年1月至2017年10月就诊的可疑颈动脉狭窄患者90例，分别进行DSCTA与CDUS检查。采用卡方检验对比斑块分布、大小、斑块性质和狭窄程度。结果90例患者双侧颈部DSCTA检查发现52例颈动脉狭窄，3例为双侧狭窄，其中轻度狭窄29例、中度狭窄9例、重度狭窄12例，完全闭塞2例；检出斑块175处，其中钙化斑块133处、混合斑块30处、脂质斑块12处。90例患者双侧颈部CDUS检查发现54处颈动脉狭窄，3例为双侧狭窄，其中轻度狭窄26例、中度狭窄10例、重度狭窄16例，完全闭塞2例；检出斑块218处，其中钙化斑块138处、混合斑块39处、脂质斑块41处。DSCTA与CDUS诊断颈动脉狭窄的差异无统计学意义（χ2=0.75，P=0.861）；CDUS检查发现了更多的可见斑块及脂质斑块， < 5 mm的小斑块（60处）检出率明显高于DSCTA（25处），差异有统计学意义（χ2=10.035，P=0.002）。结论DSCTA与CDUS对颈动脉狭窄的诊断效能均较高，具有较好的临床应用价值。CDUS对 < 5 mm斑块的检出优于DSCTA。

Comparison of digital subtraction computed tomography angiography and color doppler ultrasound on the detection rate of carotid atherosclerosis plaques and the evaluation of plaque properties and stenosis degree

ObjectiveTo compare the value of digital subtraction computed tomography angiography (DSCTA) and color doppler ultrasound (CDUS) in the detection of carotid atherosclerotic plaques, plaque properties, and degree of stenosis.MethodsA total of 90 patients suspicted with carotid artery stenosis were diagnosed in the department from January 2015 to October 2017 and examined with DSCTA and CDUS. The detection rates and plaques of carotid atherosclerotic plaques diagnosed by the two methods were observed. The nature and degree of carotid artery stenosis were compared.ResultsDSCTA examination of bilateral neck of the 90 patients revealed 52 carotid artery stenosis, 3 of which were bilateral stenosis. A total of 29 cases were diagnosed with mild stenosis, 9 cases with moderate stenosis, 12 cases with severe stenosis, and 2 cases with complete occlusion. A total of 175 plaques, including 133 calcified plaques, 30 mixed plaques, and 12 plaques, were detected. In the 90 necks of both necks, CDUS findings revealed 54 carotid stenosis, of which 3 were bilateral stenosis. Mild stenosis occurred in 26 cases, moderate stenosis in 10 cases, severe stenosis in 16 cases, and complete occlusion in 2 cases. A total of 218 plaques were detected, and they included 138 calcified plaques, 39 mixed plaques, and 41 plaques. No significant difference was observed between DSCTA and CDUS in terms of diagnosis of carotid stenosis (χ2=0.75, P=0.861). For most of the visible plaques and lipid plaques, the detection rate of < 5 mm small plaques(60) was significantly higher than that of DSCTA(25) (χ2=10.035, P=0.002).ConclusionsThe two diagnostic methods feature high diagnostic capability for carotid stenosis and desirable clinical application value. CDUS was superior to DSCTA in detecting carotid atherosderotic plaque < 5 mm in diameter.