多普勒超声和MSCTA诊断主动脉夹层的价值分析

Value of Doppler Ultrasound and MSCTA in the Diagnosis of Aortic Dissection

目的分析彩色多普勒超声与多层螺旋CT血管成像(MSCTA)诊断主动脉夹层(AD)的价值。方法收集2016年10月-2018年7月在我院经手术证实的AD患者58例,均行超声及MSCTA检查,以手术结果为金标准,分析超声、MSCTA及二者联合在AD分型中的诊断效能。结果58例患者,手术证实,Stanford A型19例,Stanford B型39例。以手术结果为金标准,超声联合MSCTA诊断AD是否为Stanford A型的敏感度为84.21%,特异度为56.41%,准确度为65.52%,较各单一检查明显提高诊断准确度(P<0.05)。超声与MSCTA对于撕脱内膜片、真假腔显示能力均为100.00%。在内膜破口、受累主动脉分支显示上,CCTA优于超声(P<0.05);而在主动脉瓣受累、主动脉瓣反流显示上,CCTA不及超声(P<0.05)。结论超声与MSCTA诊断AD各具优势,二者联合可提高AD分型诊断的准确度,为临床诊治提供重要指导。

Objective To analyze the value of color Doppler ultrasound and multi-slice spiral CT angiography(MSCTA)in the diagnosis of aortic dissection(AD).Methods A total of 58 patients with AD confirmed by surgery in the hospital from October 2016 to July 2018 were examined with ultrasound and MSCTA.With the surgical results as the golden standard,the diagnostic efficiencies of ultrasound,MSCTA and their combination in classifying AD were analyzed.Results Of the 58 patients,there were 19 cases with Stanford A type and 39 cases with Stanford B type confirmed by surgery.With the surgical results as the golden standard,the sensitivity,specificity and accuracy of ultrasound combined with MSCTA for the diagnosis of Santford type A AD were 84.21%,56.41%and 65.52%,respectively.The diagnostic accuracy was significantly higher than single examination(P<0.05).The display rate of both ultrasound and MSCTA for inner flap,true and false lumen was 100.00%.For the display of intimal rupture and affected aortic branches,CCTA was superior to ultrasound(P<0.05).For the display of aortic valve involvement and aortic regurgitation,CCTA was inferior to ultrasound(P<0.05).Conclusion Ultrasound and MSCTA have their own advantages in the diagnosis of AD.The combination of the two can improve the classifying accuracy of AD,which provides important guidance for clinical diagnosis and treatment.