多层螺旋CTA与超声对比在颈部动脉疾病的诊断价值

16-slice CT angiography versus ultrasonography in cervical artery diseases

目的通过对16层螺旋CT血管造影（CTangiography，CTA）和超声（ultrasonography，US）在颈部动脉常见病变的显示情况的对照研究，探讨CTA诊断颈部动脉病变的价值。方法对34例进行CTA、US及数字减影血管造影（digital subtraction angiography，DSA）检查的患者进行同颐性分析。以DSA结果为标准，评价CTA和US两种方法对颈部疾病的检出有无差异；根据其病变表现总结分类，了解CTA和US两种方法住颈部动脉分类病变检出的敏感度、准确度、特异度、阳性预测值及阴性预测值。结果在34例DSA检查的患者巾动脉粥样斑块106段，动脉狭窄41段，动脉闭塞11段，动脉发育纤细14段，动脉开口变异5段，病变血管共计177段。以DSA为标准，CTA对动脉粥样斑块、动脉狭窄、动脉闭塞、动脉发育纤细、动脉开口变异的显示分别为100、39、11、14、5段，共计169段；US的对上述病变的检出分别为94、33、9、13、1段，共计150段。CTA和US两种方法在颈动脉疾病的检出方面差异显著（P〈0．05）。以DSA为标准，CTA较US在颈部动脉疾病的检出上有更高的敏感性及特异性，CTA在颈部动脉分类病变检出敏感性、准确性及特异性均非常高（91．6％～100％），US在血管起始部病变的检测上明显不足。结论16层CTA较US能更全面检测颈部动脉病变。多层螺旋CTA可以作为无创性检测颈部动脉疾病的重要方法。

Objective To compare the diagnostic results of CT angiography （CTA） and uhrasonography （US） on cervical artery disease and to evaluate the diagnostic value of CTA on cervical artery lesions. Methods A retrospective study was on the results of CTA, US and DSA （digital subtraction angiography） simultaneously performed on 34 patients. Taking the diagnostic results of DSA as standard, those of CTA and US on the cervical artery disease were compared. The diseases of arteries were classified according to the findings from CTA and US to understand the sensitivity, accuracy, specificity, positive predictive value and negative predictive value of CTA and US. Results In a total of 272 vessels of 34 patients, the number of atheromatous plaques of arteries, arterial stenosis, arterial occlusion, tenuous arteries and aberrant arteries was respectively 106, 41, 11, 14, 5 by DSA （totally 177 lesions）, and 100, 39, 11, 14, 5 by CTA （totally 169 lesions） and 94, 33, 9, 13, 1 by US （ totally 150 lesions）. Significant difference was found between CTA and US in the detection of cervical artery diseases （P 〈 0.05 ） and CTA had higher sensitivity and specificity than US in the detection of cervical artery diseases. US was unsatisfied in detecting the lesions at the origin of arteries. Conclusion Spiral 16-slice CTA is more reliable than US in evaluating the lesions in cervical arteries due to its high sensitivity and specificity, and can repalce DSA.