动脉CT血管成像诊断头颈部血管疾病的价值

The value of arterial CT angiography in the diagnosis of head and neck vascular diseases

目的探讨头颈部动脉CT血管成像(CTA)检查诊断头颈部血管疾病的临床价值。方法选取2019年1月至2020年1月西安交通大学第一附属医院东院区120例疑似头颈部血管疾病患者作为研究对象,所有患者入院后分别行头颈部血管彩超(DUS)检查和头颈部CTA检查,将数字减影血管造影(DSA)检查作为金标准,比较不同检查对头颈部血管疾病的检出情况及诊断的灵敏度、准确性与特异度,比较两种检查诊断方式在头颈部血管狭窄程度方面的检出情况。结果DSA检查诊断结果显示,120例患者中92例确诊为阳性,28例为阴性;头颈部CTA检查诊断结果显示,阳性91例,阴性29例;DUS检查诊断结果显示,阳性74例,阴性46例。CTA检查诊断颈部血管疾病灵敏度、准确率分别为95.65%、94.17%,明显高于DUS检查,差异均有统计学意义(P<0.05);CTA检查对血管狭窄、粥样斑块检出率分别为45.45%、25.00%,均高于DUS检查,差异均有统计学意义(P<0.05)。结论CTA检查诊断头颈部血管疾病的灵敏度、准确率较高,能够实现对血管病变的早期鉴别及狭窄的检出,为临床治疗提供依据,可予以推广应用。

Objective To explore the clinical value of CT angiography(CTA)in the diagnosis of head and neck vascular diseases.Methods A total of 120 patients with suspected head and neck vascular disease in the East Campus of the First Affiliated Hospital of Xi′an Jiaotong University from January 2019 to January 2020 were selected as the research subjects.All patients underwent head and neck ultrasonography(DUS)and head and neck CTA after admission.Digital subtraction angiography(DSA)was used as the gold standard to compare the detection sensitivity,accuracy and specificity of different examination for head and neck vascular diseases.The detection results of the two diagnostic methods in the degree of head and neck vascular stenosis were compared.Results The diagnostic results of DSA examination showed that among the 120 patients,92 were confirmed positive and 28 were negative.The diagnostic results of head and neck CTA examination showed that 91 were positive and 29 were negative.The diagnostic results of DUS examination showed that 74 were positive and 46 were negative.The sensitivity and accuracy of CTA in the diagnosis of head and neck vascular diseases were 95.65%and 94.17%respectively,which were significantly higher than those of DUS,and the differences were statistically significant(P<0.05).The detection rates of vascular stenosis and atherosclerotic plaques by CTA were 45.45%and 25.00%respectively,which were higher than those by DUS,and the differences were statistically significant(P<0.05).Conclusion CTA examination has high sensitivity and accuracy in diagnosing head and neck vascular diseases,which could realize early identification of vascular diseases and detection of stenosis,provide a basis for clinical treatment,and could be popularized and applied.