多排螺旋CT三低扫描模式在头颈部动脉血管病变诊断中的应用效果分析

Analysis of application effect of three-low scan mode of MSCT in the diagnosis of vascular lesion of head and neck artery

目的:探究多排螺旋CT(MSCT)三低扫描模式在头颈部动脉血管病变CT血管成像(CTA)检查中的应用效果及对动脉血管狭窄程度的鉴别诊断价值。方法:选取在医院就诊的60例头颈部动脉血管病变患者,采用随机数表法将其分为扫描模式不同的常规扫描组和三低扫描组,每组30例。两组均行MSCT检查,比较两组图像客观评价参数,头颅CTA强化的平均值(SI4)、最佳信噪比(SNR)、对比噪声比(CNR)和图像背景噪声(BN),以及辐射剂量和图像质量。两组患者于2周内进行数字减影血管造影(DSA)检查,以DSA检查结果为"金标准",分析评价三低扫描组与DSA诊断一致性以及对中度及以上动脉血管狭窄的鉴别诊断价值。结果:三低扫描组SI4、SNR及CNR均高于常规扫描组(t=11.932,t=8.575,t=9.226;P<0.05);两组图像BN比较差异无统计学意义(t=0.457,P>0.05)。三低扫描组容积CT剂量指数(CTDI_(vol))、辐射剂量(ED)低于常规扫描组,图像质量评分高于常规扫描组,差异有统计学意义(t=19.154,t=22.699,t=7.581;P<0.05)。三低扫描组与DSA诊断动脉血管狭窄程度的一致性较高(Kappa=0.893),符合率为93.55%;三低扫描组诊断中度及以上动脉血管狭窄的受试者工作特征(ROC)曲线下面积(AUC)为0.928,最佳诊断灵敏度、特异度和准确率分别为88.46%、97.22%和93.55%。结论:采用MSCT三低扫描模式对头颈部动脉血管病变患者进行扫描,能够显著提高扫描图像质量,降低辐射剂量,且在诊断中度及以上动脉血管狭窄程度具有重要应用价值。

Objective:To explore the application effect of three-low scan mode of multi-slice spiral computed tomography(MSCT)in CT angiography(CTA)examination of vascular lesion of head and neck artery and the differential diagnosis value of that on the stenosis of arterial vessel.Methods:60 patients with arterial vascular lesion of head and neck who admitted to hospital were selected.And they were divided into routine scan group and threelow scan group according to the random number table method,with 30 cases in each group.Both groups underwent MSCT examination,and objective evaluation parameters of images of two groups included the intensified mean of head CTA(SI4),the optimal signal to noise ratio(SNR),the contrast to noise ratio(CNR),background noise(BN)of image,radiation dose and image quality.And within 2 weeks,a digital subtraction angiography(DSA)examination was performed to the patients of two groups.And the result of DSA examination was regarded as the"gold standard"to analyze and evaluate the consistency of MSCT three-low scan group and DSA diagnosis,and the value of differential diagnosis of that on vessel stenosis of artery with moderate degree and above moderate degree.Results:The SI4,SNR and CNR of the three-low scan group were significantly higher than those of routine scan group(t=11.932,t=8.575,t=9.226,P<0.05).The difference of image BN between two groups was not significant(t=0.457,P>0.05).The CT dose index volume(CTDI_(vol))and radiation dose(ED)of three-low scan group were significantly lower than those of routine scan group,and the score of image quality of former group was significantly higher than that of routine scan group(t=19.154,t=22.699,t=7.581,P<0.05).The coincidence of three-low scan group and DSA was higher in diagnosing the degree of the stenosis of artery vessel(Kappa=0.893),the coincidence rate of them was 93.55%.The area under the curve(AUC)of the receiver operating characteristics(ROC)curve of three-low scan group was 0.928 in diagnosing vessel stenosis of artery with moderate degree and above moderate degree.The optimally diagnostic sensitivity,specificity and accuracy of that were 88.46%,97.22%and 93.55%,respectively.Conclusion:The application MSCT three-low scan mode in scanning the patients with vascular lesion of head and neck artery can significantly improve the quality of scanned image and reduce the radiation dose.And it has important application value in diagnosing the degree of arterial stenosis with moderate degree and above moderate degree.