多层螺旋CT血管成像对颈部动脉疾病的应用价值

目的探讨多层螺旋CT血管成像（multislice CT angiography，MSCTA）对颈部动脉疾病的临床应用价值。方法对45例临床怀疑颈部动脉狭窄性病变患者行颈血管CTA检查，13例患者一侧或两侧颈动脉狭窄或闭塞，1例患者一侧椎动脉横突孔段狭窄，其中16例患者在同期行DSA检查，以DSA结果为金标准进行效果评价。结果45例患者基本满意地显示了两侧颈部动脉血管的正常结构和疾病分布情况。将每侧颈部动脉分为4个血管节段进行观察，16例可评价病例共观察128段血管。MSCTA显示不同程度狭窄的血管段共30段，与DSA结果比较，两者诊断总符合率为98．4％（124／128），MSCTA对颈部动脉狭窄诊断的总敏感度、特异度分别为100％（28／28）、98％（98／100）。MSCTA与DSA二者在诊断颈动脉狭窄上有很好的一致性。结论颈部MSCTA与DSA比较，能够清晰显示颈部动脉狭窄性病变，是一种可靠的、无创的、有应用价值的检查方法。

Diagnostic evaluation of carotid artery diseases with multislice CT angiography

Objective To study the clinicial value of multi-slice spiral CTA in the diagnosis of carotid artery diseases.Methods 45 patients suspected of carotid arterial diseases underwent MSCTA examination.Among these patients,DSA was carried out in 16 cases within two weeks.The 16 cases diagnosis based on MSCTA was compared with the DSA which was so called the "gold standard".Results All 45 cases got clear pictures which could directly and whole show normal structure of carotid artery and disease distribution.Bilateral carotid and vertebral arteries were observation object,4 vascular segments were observed in every cervical part and 128 arterial segments of 16 cases were demonstrated.Taken DSA as standard,30 arterial segments were evaluated.30 segments of arterial stenosis were diagnosed by MSCTA,and 28 segments by DSA.The rate of accordance was 98.4%(124/128),MSCTA achieved sensitivity and specificity of 100%(28/28) and 98%(98/100),respectively.Compared with DSA,there is excellent correlation among MSCTA and DSA.Conclusion Multislice CT angiography technique can accurately and comprehensively display and assess occlusive changes of the cervical arteries.It is a no-invasive,reliable and potential new technique.