CT血管造影技术对急性脑卒中患者的诊断价值研究

Study on the diagnostic value of CT angiography in patients with acute stroke

目的探究CT血管造影技术(CTA)对急性脑卒中患者的诊断价值。方法选择2016年4月至2019年4月于陕西省康复医院接受治疗的36例急性脑卒中患者为研究对象,对其进行CTA检测和数字减影血管造影(DSA)检测,CTA检测结果作为试验方法,DSA检测结果作为参考方法,评估CTA对急性脑卒中患者的诊断价值。结果所有患者总共检测了180条血管,经比较发现,两种方法对急性脑卒中患者颈动脉狭窄程度的检测结果差异均无统计学意义(P>0.05)。两种方法对血管狭窄程度的检测结果具有较高的一致性,轻度、中度、重度狭窄及闭塞的κ值均>0.6,表明其一致性较好,尤其是对重度狭窄患者,一致性为0.73。两种方法对颈动脉粥样硬化斑块检出率和斑块形态检测结果比较,差异无统计学意义(P>0.05)。CTA对36例脑侧支循环形成的检出与CTA的符合率为83.33%,两种方法检测结果差异无统计学意义(P>0.05)。两种方法对急性脑卒中患者一级侧支和二级侧支循环形成的检出具有高度的一致性(κ=0.72、0.69)。结论CTA对急性脑卒中患者颈动脉狭窄及脑侧支循环形成具有较高的检出率,并与DSA结果具有高度一致性,值得进行临床推广应用。

Objective To investigate the diagnostic value of CT angiography(CTA)in patients with acute stroke.Methods A total of 36 patients with acute stroke who were treated in Shaanxi Kangfu Hospital from April 2016 to April 2019 were selected as the research objects,and CTA detection and digital subtraction angiography(DSA)were performed on the patients.The results of CTA were taken as the experimental group,and the DSA results as the control group.The diagnostic value of CTA in patients with acute stroke were compared and evaluated.Results A total of 180 blood vessels were detected in all patients.After comparison,it was found that there was no significant difference in the detection results of different carotid artery stenosis in patients with acute stroke(P>0.05).The two methods had high consistency in diagnosing the degree of vascular stenosis.Theκvalues of mild,moderate,severe stenosis and occlusion are all greater than 0.6,indicating that the consistency was good,especially for patients with severe stenosis,and the consistency was as high as 0.73.There was no significant difference in the results of detection rate of carotid atherosclerotic plaque and plaque morphology between two methods(P>0.05).The detection coincidence rate of CTA in the formation of cerebral collateral circulation in 36 cases was 83.33%,and the difference between the two groups was not statistically significant(P>0.05).CTA was highly consistent in the detection of primary and secondary collaterals in patients with acute stroke(κ=0.72 and 0.69).Conclusion CTA has a high detection rate of carotid artery stenosis and cerebral collateral circulation formation in patients with acute stroke,and has high consistency with DSA results,which is worthy of clinical promotion and application.