CDUS、CTA及DSA在颈动脉狭窄病变诊断中的临床价值

Clinical Value of CDUS, CTA and DSA in the Diagnosis of Carotid Stenosis Lesions

目的研究颈部彩色多普勒超声(CDUS)、CT血管造影(CTA)与数字减影血管造影(DSA)在劲动脉狭窄病变诊断中的临床价值。方法收集我院神经内科2016年1月-2018年1月间收治的60例疑似颈动脉狭窄病变患者影像学检查资料,探究CDUS、CTA及DSA在颈动脉狭窄病变中的应用价值。结果①60例患者中有42例行CDUS与DSA检查、有31例患者行CTA与DSA检查、有24例行CDUS、CTA及DSA检查。②以DSA检查结果为血管狭窄诊断的金标准,CDUS在颈动脉狭窄诊断中的灵敏度、特异度及准确度分别为62.50%、72.22%、66.67%,CTA分别为76.19%、80.00%、77.42%,CDUS+CTA分别为80.00%、75.00%与79.17%。③经比较发现,CDUS+CTA不稳定斑块检出率最高,其次为单纯CDUS、CTA,DSA斑块检出率最低。结论 DSA依旧是血管狭窄诊断的金标准,但CTA联合CDUS在高危人群及心血管疾病患者院外长期随访中具有优势性,且CDUS联合CTA在甄别易损斑块中也具有良好的应用价值。

Objective To study the clinical value of color Doppler ultrasound(CDUS),CT angiography(CTA)and digital subtraction angiography(DSA)in the diagnosis of carotid stenosis lesions.Methods The imaging examination data of 60 patients suspected as carotid stenosis lesions who were admitted to our Department of Neurology from January 2016 to January 2018 were collected.The application value of CDUS,CTA and DSA in carotid stenosis lesions was explored.Results Among 60 patients,42 cases were given CDUS and DSA,and 31 cases were given CTA and DSA,and 24 cases were given CDUS,CTA and DSA.The DSA results were used as the gold standard for the diagnosis of vascular stenosis,and the sensitivity,specificity and accuracy of CDUS in the diagnosis of carotid stenosis were 62.50%,72.22%and 66.67%respectively,and the three indexes of CTA were 76.19%,80.00%and 77.42%respectively,and the three indexes of CDUS+CTA were 80.00%,75.00%and 79.17%respectively.It was found that the detection rate of unstable plaque was the highest by CDUS+CTA,followed by single CDUS and CTA,and the detection rate ofplaques was the lowest by DSA.Conclusion DSA is still the gold standard for the diagnosis of vascular stenosis,but CTA combined with CDUS is superior in longterm out-of-hospitalfollow-up of high-risk population and patients with cardiovascular diseases.CDUS combined with CTA also has good application value in screening vulnerable plaques.