肠系膜血管超声与CTA对急诊急性肠系膜血管栓塞的诊断对比

Comparison of mesenteric vascular ultrasound and CTA in the diagnosis of emergency acute mesenteric vascular embolism

目的比较肠系膜血管超声与CT血管造影(CTA)对急诊急性肠系膜血管栓塞的诊断价值,为临床诊断提供参考依据。方法选择2018年10月—2020年10月浙江省台州医院急诊科收治的80例疑似急性肠系膜血管栓塞患者为研究对象,所有患者均行超声、CTA及数字减影血管造影(DSA)检查;以DSA诊断结果为金标准,分析肠系膜血管超声与CTA的诊断价值。结果肠系膜血管超声诊断急性肠系膜血管栓塞的敏感度为86.49%、特异性为100.00%、阳性预测值为100.00%、阴性预测值为37.50%,约登指数为0.865;CTA诊断急性肠系膜血管栓塞的敏感度为97.30%、特异性为100.00%、阳性预测值为100.00%、阴性预测值为75.00%,约登指数为0.973。CTA诊断急性肠系膜血管栓塞的敏感度高于肠系膜血管超声,差异有统计学意义(P<0.05)。结论两种检查方法均有利于急诊科对该病疾病类型与病因的诊断,CTA对急诊急性肠系膜血管栓塞的敏感性较肠系膜血管超声更高,值得应用。

Objective To compare the diagnostic value of mesenteric vascular ultrasound and CT angiography(CTA)in emergency acute mesenteric vascular embolism,so as to provide a reference for clinical diagnosis.Methods From October 2018 to October 2020,80 patients with suspected acute mesenteric vascular embolism admitted to Department of Emergency,Zhejiang Taizhou Hospital were selected as study objects.All patients underwent mesenteric vascular ultrasound,CTA and digital subtraction angiography(DSA)examinations.DSA diagnosis results as the gold standard,and the diagnostic value of mesenteric vascular ultrasound and CTA were analyzed.Results The sensitivity of mesenteric vascular ultrasound was 86.49%,the specificity was 100.00%,the positive predictive value was 100.00%,the negative predictive value was 37.50%,and Youden index was 0.865;the sensitivity of CTA was 97.30%,the specificity was 100.00%,and the positive predictive value was 100.00%,negative predictive value was 75.00%,Youden index was 0.973.The sensitivity of CTA in the diagnosis of acute mesenteric vascular embolism was higher than that of mesenteric vascular ultrasound,and the difference was statistically significant(P<0.05).Conclusion Both methods are beneficial to the diagnosis of the disease types and etiology in the emergency department,and CTA is more sensitive to acute mesenteric vascular embolism than mesenteric vascular ultrasound,which is worthy of application.