大脑中动脉狭窄的TCD、CTA、DSA检测对比研究

Comparison of TCD,CTA,DSA in detecting middle cerebral artery stenosis

目的以数字减影脑血管造影(DSA)为参照,比较TCD、CTA、DSA诊断大脑中动脉狭窄的准确性,评价其临床价值。方法对40例经DSA确诊的单双例72处大脑中动脉狭窄的患者,回顾分析TCD、CTA的检查结果,比较其对大脑中动脉(MCA)M1段、M2段狭窄诊断的准确率。结果TCD、CTA、DSA诊断MCA M1段、M2段狭窄的准确率分别为82.5%、96.5%、100%及26.7%、80.0%、100%。三者对MCA M1段狭窄的诊断差异无显著性(P>0.05),而诊断M2段狭窄,TCD与CTA、DSA比较有显著差异(P<0.05),CTA与DSA无显著差异(P>0.05)。结论CTA、DSA均能准确显示MCA狭窄,TCD有局限性,均能为临床提供诊断价值。

Objective To evaluate the accuracy and clinical diagnostic values of TCD,CTA,DSA in detecting middle cerebral artery stenosis using DSA as reference. Methods Forty patients with 72 stenosis in unilateral or bilateral MCA diagnosed by DSA, were retrospectively analyzed of TCD,CTA imaging findings and compared of the diagnostic accuracy in M1 and M2 stenosis. Results The accuracy of TCD, CTA, DSA in M1 stenosis was 81.6 %, 97.4%, 100% respectively. And that in M2 stenosis was 26.7%, 80.0%, 100% respectively. There was no difference in diagnosis of M1 stenosis （P〉0.05）. There was no difference in diagnosis of M2 stenosis with CTA,DSA（P〉0.05）. But there was obvious difference in M2 stenosis with TCD （P〈0. 05）. Conclusion CTA, DSA all have high accuracy of detecting MCA stenosis but TCD. They play a role in diagnosis of MCA stenosis.