超声联合CT血管造影在脑梗死患者颈动脉斑块诊断中的应用价值

The Value of Ultrasound Combined with CT Angiography in the Diagnosis of Carotid Plaque in Patients with Cerebral Infarction

目的 探讨超声联合CT血管造影(CTA)在脑梗死患者颈动脉斑块诊断中的应用价值。方法 选取2019年9月至2022年5月医院收治的200例脑梗死患者作为研究对象,均实施颈动脉超声、CTA及数字减影血管造影(DSA)检查,以DSA检查结果为金标准,分析超声、CTA单独及联合诊断与金标准的一致性,统计超声、CTA单独及联合诊断颈动脉斑块的效能。结果 200例患者中,DSA诊断阳性163例、阴性37例。超声、CTA单独诊断与金标准的一致性均较差(Kappa=0.224、0.258),超声联合CTA诊断与金标准的一致性较好(Kappa=0.841)。超声联合CTA诊断诊断颈动脉斑块的灵敏度、特异度、准确度、阳性预测值、阴性预测值均高于两者单独诊断,差异均有统计学意义(P<0.05)。结论 超声联合CTA对脑梗死患者颈动脉斑块的诊断与金标准的一致性较好,且诊断效能高于两者单独诊断,可对颈动脉斑块病变进行初步评估。

Objective The value of ultrasound combined with CT angiography(CTA) in the diagnosis of carotid plaque in patients with cerebral infarction was investigated.Methods With selection of 200 patients with cerebral infarction admitted to the hospital from September 2019 to May 2022 as the study subjects,carotid artery ultrasound,CTA and digital subtraction angiography(DSA) were performed.With the results of DSA examination as the gold standard,the consistency of ultrasound,CTA alone and combined diagnosis with the gold standard was analyzed,and the efficacy of ultrasound,CTA alone and combined diagnosis of carotid artery plaque was counted.Results Among 200 patients with cerebral infarction,diagnosed by DSA,163 were positive and 37 were negative.The consistency of ultrasound and CTA alone with the gold standard was general(Kappa=0.224,0.258),while the consistency of the two combined with the gold standard was good(Kappa=0.841).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of ultrasound combined with CTA in the diagnosis of carotid plaque were higher than those of the two independent diagnoses,and the difference was statistically significant(P0.05).Conclusion The diagnosis of carotid plaque in patients with cerebral infarction by ultrasound combined with CTA is in good agreement with the gold standard,and the diagnostic efficiency is higher than that of the two alone,which can be used for preliminary evaluation of carotid plaque lesions.