多层螺旋CT血管造影评价颅内血管狭窄和闭塞性疾病的临床价值

The clinical value of multi-slice CT angiography in evaluation of intracranial artery stenosis and occlusive disease

目的通过与DSA的比较评价多层螺旋CT血管造影(CTA)诊断颅内血管狭窄和闭塞的临床价值。方法32例缺血性脑血管病的患者,其中男性23例,女性9例,年龄48～75岁,平均年龄57岁。接受了CTA和DSA检查。2项检查均在入院后15d内完成。分别测量CTA和DSA影像中动脉的狭窄程度和动脉狭窄处的管腔直径。结果以DSA作为参考标准,CTA发现病变的数量为74个,病变数量和病变部位的判断与DSA一致。CTA诊断颅内动脉中度狭窄的敏感度、特异度和准确度分别为94.3%、98.8%和98.6%;重度狭窄分别为73.7%、99.7%和99.7%;闭塞分别为91.7%、99.8%和100%。CTA与DSA测量狭窄程度及狭窄处管腔直径的能力无统计学差异。结论CTA是一种诊断动脉狭窄和闭塞性疾病的可靠方法,在许多情况下CTA检查结果的特异度和精确度与DSA相当。

Objective To evaluate the clinical value of multi-slice CT angiography （CTA） in diagnosis of intracranial artery stenosis and occlusion compared with DSA measure. Methods A total of 32 patients with ischemic cerebrovascular lesions were enrolled, male 23 ,female 9, aged 48 - 75 years, mean age 57 years. All patients were performed CTA and DSA （digital subtal angiography） . Two studies were performed within a 15 day period. Two radiologists reviewed the CTA and DSA images independently. The steonsis rates were calculated and graded, and the narrowest portion of stenosis lumen diameter was measured. Results The DSA data was defined as the reference standard. And 74 abnormal artery segments were found by CTA, the lesion numbers and location of the stenosis were coincided with DSA results. The sensitivity, specificity and accuracy of CTA in diagnosis the moderate stenosis were 94.3 % ,98.8 % and 98.6 % respectively;severe stenosis were 73,7 % ,99.7 % and 99.7 % ; occlusion were 91.7 % ,99.8 % and 100 % ,respectively. The difference between CTA and DSA in evaluation stenosis rates and steonsis lumen diameter had no statistical significance. Conclusion The CTA is a reliable approach in evaluating the intracranial stenosis and occlusion. The specificity and accuracy of CTA results are similar to that of DSA in most cases.