彩色多普勒超声与X线计算机断层血管成像在颈动脉狭窄中的诊断价值

Diagnostic value of color Doppler ultrasonography and computed tomography angiography in carotid artery stenosis

目的 探究彩色多普勒超声检查(color Doppler ultrasonography, CDUS)、X线计算机断层血管成像(computed tomography angiography, CTA)在颈动脉狭窄中诊断价值。方法 选择2020年3月—2022年3月开封市中医院收治疑似116例颈动脉狭窄患者相关资料予以回顾性分析,患者均接受CDUS、CTA和DSA检查,将DSA检出颈动脉狭窄结果作为金标准,评估CDUS、CTA对于颈动脉狭窄诊断价值。结果 以DSA作为金标准,CDUS诊断颈动脉中重度狭窄灵敏度、特异度以及准确度均低于CTA,两种方式诊断灵敏度、特异度比较没有统计学意义(P>0.05),CDUS与CTA诊断颈动脉狭窄与DSA一致性分别为0.432、0.803;CDUS、CTA对于右侧、左侧以及双侧颈动脉中重度狭窄位置检出情况比较没有统计学意义(P>0.05);CDUS、CTA检出颈动脉中重度狭窄患者斑块数分别为153个、169个,CDUS、CTA对于斑块活动度检出率比较没有统计学意义(P>0.05)。结论 CDUS、CTA、DSA可以检出颈动脉中重度狭窄、狭窄血管分布情况,但是CTA在颈动脉中重度狭窄优势优于CDUS。

Objective To investigate the diagnostic value of color Doppler ultrasonography(CDUS) and computed tomography angiography(CTA) in carotid artery stenosis. Methods The relevant data of 116 patients with suspected carotid artery stenosis admitted to the hospital from March 2020 to March 2022 was retrospectively analyzed. The patients were examined with CDUS, CTA and DSA. The DSA results were taken as the golden tandard to evaluate the diagnostic value of CDUS and CTA in carotid artery stenosis. Results With DSA as the golden standard, the sensitivity, specificity and accuracy of CDUS to diagnose moderate to severe carotid artery stenosis were lower than those of CTA. The sensitivity and specificity of the two diagnostic methods were similar(P>0.05). The Kappa values of CDUS and CTA to diagnose carotid stenosis were 0.432 and 0.803, respectively. There was no statistically significant difference between CDUS and CTA in the detection of moderate to severe stenosis of right, left and bilateral carotid arteries(P>0.05). 153 and 169 plaques in patients with moderate to severe stenosis were detected by CDUS and CTA, respectively. There was no statistically significant difference among the three examination methods in the detection rates of soft plaques and mixed plaques(P>0.05). The detection rate of hard plaques by CTA was significantly higher than that by CDUS(P<0.05). Conclusion CDUS, CTA and DSA can detect moderate to severe carotid artery stenosis and the distribution of stenotic vessels, but CTA is superior to CDUS in evaluating moderate to severe carotid artery stenosis and hard plaque.