64排多层螺旋CT血管内成像在颈动脉狭窄诊断中的应用

Application of 64-slice spiral CT angiography in the diagnosis of carotid artery stenosis

目的研究64排多层螺旋CT血管内成像(CTA)在颈动脉狭窄检查中的应用效果。方法选择2018年10月至2020年10月韶关市第一人民医院收治的68例疑似颈动脉狭窄患者为研究对象,均进行CTA和数字减影血管造影术(DSA)检查,以DSA检查为颈动脉狭窄诊断的金标准,对比64排螺旋CTA与DSA对颈动脉狭窄诊断结果,并观察64排螺旋CTA对颈动脉斑块形态的检查情况。结果64排螺旋CTA对颈动脉狭窄程度诊断的总准确率为95.40%,其中对颈动脉无狭窄、轻度狭窄诊断的准确率分别为96.39%、86.21%,与DSA检查结果比较差异均有统计学意义(P<0.05);64排螺旋CTA对颈动脉中度狭窄、重度狭窄及闭塞诊断的准确率分别为95.00%、100.00%、100.00%,与DSA比较差异均无统计学意义(P>0.05);64排螺旋CTA诊断颈动脉狭窄的准确率为95.59%(65/68),灵敏度为96.49%(55/57),特异度为90.91%(10/11);64排螺旋CTA提示颈动脉粥样硬化斑块共89个,其中溃疡斑块9个,占10.11%,不规则斑块22个,占24.72%,光滑斑块58个,占65.17%。结论64排螺旋CTA检查在颈动脉狭窄诊断中有较高的特异度、灵敏度及准确性,与DSA检查结果的一致性较高,为无创、安全、有效的检查手段。

Objective To study the application of 64-slice spiral CT angiography(CTA)in the examination of carotid artery stenosis.Methods A total of 68 patients with suspected carotid artery stenosis admitted to Shaoguan First People’s Hospital from October 2018 to October 2020 were selected for 64-row multi-layer spiral CTA and digital subtraction angiography(DSA)examination.Taking DSA examination as the gold standard for the diagnosis of carotid artery stenosis,the diagnostic results of 64-slice multislice spiral CTA and DSA in carotid artery stenosis were compared,and the examination of 64-slice multislice spiral CTA in carotid artery plaque shape was observed.Results The overall accuracy of 64-row multislice spiral CTA in the diagnosis of carotid artery stenosis was 95.40%,and the accuracy of 64-row multislice spiral CTA in the diagnosis of no stenosis or mild stenosis was 96.39%and 86.21%,respectively,which showed significant difference with those of DSA(P<0.05).The diagnostic accuracy of 64-row multislice spiral CTA in the diagnosis of moderate stenosis,severe stenosis,and occlusion of carotid artery were 95.00%,100.00%and100.00%,respectively,which showed no significant difference with those of DSA(P>0.05).The accuracy,sensitivity,and specificity of 64-slice spiral CTA in the diagnosis of carotid artery stenosis were 95.58%(65/68),96.49%(55/57),and90.91%(10/11).64-slice spiral CTA showed 89 carotid atherosclerotic plaques,including 9 ulcer plaques(accounting for10.11%),22 irregular plaques(accounting for 24.72%),and 58 smooth plaques(accounting for 65.17%).Conclusion The64-row multislice spiral CTA examination has high specificity,sensitivity and accuracy in the diagnosis of carotid artery stenosis,and is consistent with the results of DSA examination.It is a non-invasive,safe and effective examination method.