不同血管检查方法对颈内动脉狭窄的诊断价值对比

Different vascular imaging diagnosis of internal carotid artery system comparison

目的探讨经颅多普勒超声(TCD)、CT血管成像(CTA)及数字减影血管造影(DSA)在颈内动脉狭窄诊断中的临床应用价值。方法选取我院2008年6月至2010年9月收治的60例高度怀疑颈内动脉狭窄的患者行TCD、DSA与头颅CTA检查,以DSA诊断为金标准,比较TCD和CTA检查的敏感性、特异性和符合率。结果 60例患者480条受检的血管中,经DSA检查为轻度、中度、重度狭窄的血管条数分别为38条,57条及55条。CTA、TCD检查的敏感性、特异性和符合率分别为95.5%、80.0%、92.7%和87.1%、75.0%、80.7%。TCD结果显示重度狭窄段的收缩期流速显著高于中度狭窄段的流速,P<0.05。结论 CTA、DSA均能准确显示颈内动脉狭窄,TCD可作为对重度狭窄具有较高诊断价值的无创首选检查。

Objective To investigate transcranial Doppler （ TCD ）, CT angiography （ CTA ） and digital subtraction angiography （DSA） in carotid artery stenosis in clinical applications. Methods In our hospital from June 2008 to December 2009, 60 patients who were highly suspected as carotid artery stenosis underwent TCD, DSA and CTA, head to DSA as the gold standard for diagnosis, compared TCD and CTA, the sensitivity of specific and consistent rate. Results 60 patients with 480 vessels were inspected by the DSA as normal, moderate and severe stenosis of the aortic strips, were respectively 38, 57 and 55. The sensitivity, specificity, and accordance rate was 95.5%, 80.0%, 92.7% and 87.1%, 75.0%, 80.7%. TCD showed severe stenosis of the systolic velocity of CTA, TCD were significantly higher than moderate stenosis of the velocity（ P 〈 0.05 ）. Conclusion CTA, DSA can accurately show the internal carotid artery stenosis, TCD has high diagnostic value of the severe sterosis.