128层螺旋CT体层血管成像对颅内血管狭窄或闭塞的诊断价值分析

Diagnostic value of 128 slice spiral CT angiography for intracranial vascular stenosis or occlusion

目的分析128层螺旋CT体层血管成像(CT angiography,CTA)对颅内血管狭窄或闭塞的诊断价值。方法选取2015年12月至2017年12月本院收治的临床高度怀疑颅内血管狭窄或闭塞的80例患者为研究对象,均行128层螺旋CTA检查及数字减影血管造影(digital substraction angiography,DSA)检查,分析128层螺旋CTA的影像特点、图像质量及其评估的血管狭窄程度,并以DSA诊断结果为金标准,评估128层螺旋CTA的诊断效能。结果 80例患者均完成128层螺旋CTA检查,共检查颅内血管165根,其中轻度狭窄32根(19.39%),中度狭窄14根(8.48%),重度狭窄6根(3.64%),闭塞3根(1.82%),正常110根(66.67%);128层螺旋CTA对165根血管中1级、2级、3级可评价血管的显示率分别为86.67%、10.91%、2.42%,均显著高于DSA(75.16%、19.39%、5.45%)(P_均<0.05);以DSA诊断结果为金标准,128层螺旋CTA诊断颅内血管狭窄或闭塞的灵敏度、特异度、准确度、阳性预测值、阴性预测值、Kappa值分别为96.23%、96.43%、96.36%、92.73%、98.18%、0.917。结论 128螺旋CTA诊断颅内血管狭窄或闭塞可获得较好的图像质量,能够准确评估颅内血管狭窄或闭塞情况。

Objective To analyze the diagnostic value of128slice spiral CT angiography(CTA)for intracranial vascular stenosis or occlusion.Method80patients with clinically highly suspected intracranial vascular stenosis and occlusion who were admitted to our hospital from December2015to December2017were selected as objects of study.All of them underwent128slice spiral CTA and digital substraction angiography(DSA).The image features and image quality of128slice spiral CTA and the degree of vascular stenosis were analyzed.The diagnostic efficiency of128slice spiral CTA was evaluated with the Result s of DSA as the golden standard.Result All the80patients completed CTA,a total of165intracranial vessels were examined,including32vessels(19.39%)with mild stenosis,14vessels(8.48%)with moderate stenosis,6vessels(3.64%)with severe stenosis,3vessels(1.82%)with occlusion and110normal vessels(66.67%).The display rates of evaluable blood vessels with grade1,grade2and grade3in the165blood vessels by128slice spiral CTA were86.67%,10.91%and2.42%,respectively,better than those by DSA(75.16%,19.39%,5.45%)(Pall<0.05).The sensitivity,specificity,accuracy,positive predictive value,negative predictive value and Kappa value by128slice spiral CTA in diagnosing intracranial vascular stenosis or occlusion were96.23%,96.43%,96.36%,92.73%,98.18%and0.917,respectively,with diagnostic Result s of DSA as the golden standard.Conclusion128spiral CTA can get relatively better image quality and accurately evaluate the condition of intracranial vascular stenosis and occlusion.