64层螺旋CT血管造影在诊断颅颈部血管病变中的应用

The clinical value of 64-slice sprial CT angiography in the diagnosis of cranial and neck vascular diseases

目的:探讨64层螺旋CT用于颅颈部血管成像的技术操作要点,分析影响成像质量的因素,评价64层螺旋CT无创性颅颈部血管造影在诊断颅颈部血管疾病中的临床应用价值。方法:对进行了CTA检查的50例怀疑颅颈部血管疾病患者的资料进行回顾性分析,以DSA及手术结果为金标准,评价CTA在颅颈部血管病变的诊断敏感性与准确性。结果:64层螺旋CT利用CTA显示动脉280节段,其中动脉狭窄235节段。与DSA或手术结果比较,符合的有260节段,不符合有20节段,不相符处主要表现在动脉狭窄的评估方面。CTA显示正常37节段,与DSA比较,符合31节段,不符合6节段。在所有检查结果中,以DSA或手术结果为金标准,经计算,其敏感性为97.4%。采用χ2检验统计学分析,CTA检查结果与DSA或手术结果之间差别无统计学意义。结论:64层螺旋CT颅颈部CTA成像无创、经济,简单易行,既能显示管腔又能显示管壁情况,弥补了DSA的不足。在颅颈部血管病变的诊断中具有较高的敏感性,可作为一种有效的无创性检测手段广泛用于颅颈部血管疾病的筛查、诊断和随访中。

Objective：The purpose of this study was to investigate the main characleristics of 64-slice sprial CT angiography （CTA） in displaying vessels of cranial and neck, to analyze the factors affecting image quality, and to evaluate the clinical value of CTA in diagnosing cranial and neck vascular disease. Methods：We investigated retro spectively 50 patients with or probably with cranial or neck vascular diseases who had CTA examination. Comparing the patients＇ images with the result of DSA or operation, we evaluated the sensitivity and accuracy of CTA in diagnosing cranial and neck vascular disease. Results：Of the 280 segments of arteria in the 50 cases, 235 segments of arteria were stenosis by CTA; 260 were confirmed and 20 were not confirmed by DSA or operation. The main difference of the results lay in diagnosing the degree of stenosis. 31 of 37 normal diagnosis were confirmed by DSA. The main reason leading to the different results of the other there cases was the patients＇ uncooperation and the bad effect of subtraction. The sensibility of CTA in diagnosing all the patients was 97.4%. No significant difference was detected by X^2 test between them. Conclusion： As a cheap, quick, convenient and non-invasive method, 64-slice CTA can display both the artery wall and lumen, and make up the insufficiency of DSA. Under the control of the factors affecting image quality seriously, CTA possesses high sensitivity in the diagnosis of cranial and neck vascular disease. 64- slice CTA can be used widely as a primary method to screen, diagnose, and track cranial or neck Vascular diseases.