64排CT、CTA及1.5T MRA对大脑中动脉狭窄诊断价值的对照研究

The clinical application value of 64-CT CTAand 1.5TMRA on the diagnosis of the middle cerebral artery stenosis

目的通过与DSA的比较,评价1.5TTOF MRA和64排螺旋CT CTA在诊断大脑中动脉狭窄中的临床应用价值。方法收集2010年1月～2011年12月在我院行MRA、CTA及DSA检查的脑血管病患者146人。以DSA为标准,计算MRA、CTA诊断大脑中动脉狭窄的特异度、灵敏度等。结果 MRA检查大脑中动脉(MCA)轻度狭窄的灵敏度、特异度分别为70.6%、92.6%;CTA检查MCA轻度狭窄的灵敏度、特异度分别为72.2%、94.2%;MRA检查MCA中度狭窄的灵敏度、特异度分别为85.4%、93.0%;CTA检查MCA中度狭窄的灵敏度、特异度分别为88.2%、94.0%;MRA检查MCA重度狭窄的灵敏度、特异度分别为85.4%、95.4%,CTA诊断大脑中动脉重度狭窄的灵敏度、特异度分别为90%、97.1%;MRA诊断大脑中动脉闭塞的灵敏度、特异度为100%、95.7%。CTA诊断大脑中动脉闭塞的灵敏度、特异度分别为100%、98.5%。结论 CTA诊断MCA狭窄的灵敏度及特异度比MRA高,因此CTA在代替DSA,作为MCA狭窄筛选手段时,能够提供较MRA更准确的结果。

Objective To evaluate the clinical application of the 64-slice CTCTA and MRA on the diagnosis of the middle cerebral artery stenosis through a study in comparison with DSA.Methods 146 patients with cerebrovascular disease were chosen who had undergone MRA,CTA and DSA examination in our hospital from January 2010 to December 2011.DSA as a standard to calculate the specificity and sensitivity in MRA,CTA diagnosis of middle cerebral artery stenosis.Results The Sensitivity,specificity in MRA diagnosis of mild degree MCA stenosis were70.6%,92.6%;In CTA diagnosis of mild degree MCA stenosis it were 72.2%,94.2%;In Moderate degree MCA stenosis,it was 85.4%,93.0%of MRA;In Moderate degree MCA stenosis,it was 88.2%,94%of CTA.In MRA diagnosis of severe degree MCA stenosis,it was 85.4%,95.4%;In CTA diagnosis of severe degree MCA stenosis,it was 90%,97.1%;In MRA diagnosis of MCA obstruction,it was 100%,95.7%.In CTA diagnosis of MCA obstruction,it was 100%,98.5%.Conclusions In CTA diagnosis of MCA stenosis the sensitivity and specificity is higher than in MRA.Therefore,CTA can provide more accurate results when it replaces DSA to become a general choice for cerebrovascular stenosis screening test.