颈部血管超声联合CT血管造影对脑梗死患者颈动脉斑块的诊断价值

Diagnostic Value of Carotid Doppler Ultrasonography Combined with CT Angiography for Carotid Artery Plaque in Patients with Cerebral Infarction

目的分析颈部血管超声联合CT血管造影(CTA)对脑梗死患者颈动脉斑块的诊断价值。方法选择2020年1月至2021年8月北京市隆福医院收治的120例脑梗死患者,经数字减影血管造影检查证实,存在颈动脉斑块72例。所有患者行颈部血管超声和CTA检查,以数字减影血管造影为诊断颈动脉斑块的“金标准”,颈部血管超声、CTA及二者联合诊断脑梗死患者颈动脉斑块的灵敏度、特异度比较采用χ^(2)检验。结果颈部血管超声诊断颈动脉斑块的灵敏度、特异度、正确率分别为66.67%、91.67%、76.67%,CTA诊断颈动脉斑块的灵敏度、特异度、正确率分别为68.06%、89.58%、76.67%,二者联合诊断颈动脉斑块的灵敏度、特异度、正确率分别为88.89%、95.83%、91.67%。二者联合诊断颈动脉斑块的灵敏度分别高于颈部血管超声、CTA单独诊断(P<0.05)。结论颈部血管超声联合CTA能在一定程度上降低脑梗死患者颈动脉斑块的误诊率,提高脑梗死患者颈动脉斑块的诊断正确率。

Objective To analyze the diagnostic value of carotid Doppler ultrasonography combined with CT angiography(CTA)for carotid artery plaque in patients with cerebral infarction.Methods A total of 120 patients with cerebral infarction treated in Beijing Longfu Hospital from January 2020 to August 2021 were selected.A total of 72 cases carotid artery plaque were confirmed by digital subtraction angiography.All patients underwent carotid Doppler ultrasonography and CTA.Taking digital subtraction angiography as the"gold standard"for the diagnosis of carotid artery plaque,the sensitivity and specificity of carotid Doppler ultrasonography,CTA and their combination in the diagnosis of carotid artery plaque in patients with cerebral infarction were compared byχ^(2) inspection.Results The sensitivity,specificity and accuracy of carotid Doppler ultrasonography in the diagnosis of carotid artery plaque were 66.67%,91.67%and 76.67%,respectively.The sensitivity,specificity and accuracy of CTA in the diagnosis of carotid artery plaque were 68.06%,89.58%and 76.67%,respectively.The sensitivity,specificity and accuracy of their combination in the diagnosis of carotid artery plaque were 88.89%,95.83%and 91.67%,respectively.The sensitivity of their combination in the diagnosis of carotid artery plaque was higher than that of carotid Doppler ultrasonography and CTA alone(P<0.05).Conclusion Carotid Doppler ultrasonography combined with CTA can reduce the misdiagnosis rate of carotid artery plaque in patients with cerebral infarction and improve the diagnostic accuracy.