50mL对比剂CTA老年脑血管狭窄诊断中的价值及图像质量研究

Study on the diagnostic value and image quality of 50mL contrast medium CTA in elderly cerebral vascular stenosis

目的探讨低剂量对比剂CT血管造影(CTA)检查在诊断脑血管狭窄患者中的价值及对图像质量的影响。方法选取我院既往(2019年1月~2021年6月)采用CTA、数字剪影血管造影(DSA)检查诊断的120例脑血管狭窄患者的影像学资料进行回顾性分析,其中60例患者接受50ml碘海醇造影(低剂量组)、另外60例患者接受70ml碘海醇造影(高剂量组),以DSA检查结果作为金标准,计算两种对比剂在诊断脑血管狭窄与DSA结果的一致性。结果低剂量CTA、高剂量CTA诊断颈内动脉、大脑前动脉、大脑中动脉、基底动脉、椎动脉的信噪比值比较,差异均无统计学意义(P>0.05);低剂量CTA诊断脑血管狭窄与DSA诊断结果具有较高的一致性,Kappa=0.753,P=0.000<0.05;高剂量CTA诊断脑血管狭窄与DSA诊断结果具有较高的一致性,Kappa=0.793,P=0.000<0.05;低剂量CTA诊断脑血管狭窄的灵敏度为94.62%、特异度为93.69%;高剂量CTA诊断脑血管狭窄的灵敏度为96.77%、特异度为94.86%。结论50ml碘海醇造影与70ml碘海醇造影CTA在诊断脑血管狭窄或闭塞中均具有较好的临床效果,两种方法诊断结果与DSA的一致性差异不大,影像学信噪比值无显著差异。

Objective:To explore the value of low-dose contrast medium CT angiography(CTA)in the diagnosis of patients with cerebral vascular stenosis and its influence on image quality.Methods:The imaging data of 120 patients with cerebrovascular stenosis diagnosed by CTA and digital silhouette angiography(DSA)in our hospital(from January 2019 to June 2021)were selected for retrospective analysis,and 60 patients received 50ml iodine.Hexolography(low-dose group),another 60 patients received 70ml iohexol contrast(high-dose group),with DSA results as the gold standard,the consistency of the two contrast agents in the diagnosis of cerebral vascular stenosis and DSA results was calculated.Results:There was no significant difference in signal-to-noise ratio between low-dose CTA and high-dose CTA in the diagnosis of internal carotid artery,anterior cerebral artery,middle cerebral artery,basilar artery and vertebral artery(P>0.05);Low-dose CTA diagnosis of cerebrovascular stenosis has high consistency with DSA diagnosis results,Kappa=0.753,P=0.000<0.05;high-dose CTA diagnosis of cerebrovascular stenosis has high consistency with DSA diagnosis results,Kappa=0.793,P=0.000<0.05;the sensitivity of low-dose CTA in diagnosing cerebrovascular stenosis was 94.62% and the specificity was 93.69%;the sensitivity of high-dose CTA in diagnosing cerebrovascular stenosis was 96.77% and the specificity was 94.86%.Conclusion:50ml iohexol angiography and 70ml iohexol angiography CTA have good clinical effect in the diagnosis of cerebrovascular stenosis or occlusion.There is no significant difference between the diagnostic results of the two methods and DSA,and there is no significant difference in imaging signal-to-noise ratio.