脑计算机断层扫描血管成像对急性缺血性脑卒中的筛查价值

Screening value of cerebral computer tomography angiography for acute ischemic stroke

目的 探讨脑计算机断层扫描血管成像(CTA)对急性缺血性脑卒中的筛查价值。方法 收集2020年5月至2022年7月于民航总医院接受脑CTA检查的160例疑似急性缺血性脑卒中患者的临床资料。收集患者的基本临床特征,包括年龄、性别、基础病史、入院时的实验室检查结果、影像学检查结果、发病信息等。以临床综合诊断结果为金标准,评价脑CTA对急性缺血性脑卒中的诊断价值,同时分析其对罪犯血管的评估价值。结果 住院期间经进一步临床综合检查发现,160例疑似急性缺血性脑卒中患者中,最终确诊为急性缺血性脑卒中的患者127例,非急性缺血性脑卒中患者33例。脑CTA诊断急性缺血性脑卒中的灵敏度为97.6%(124/127),特异度为93.9%(31/33),漏诊率为2.4%(3/127),误诊率为6.1%(2/33),约登指数为0.916,阳性预测值为0.984,阴性预测值为0.912,Kappa指数为0.906(P﹤0.01)。结论 脑CTA对急性缺血性脑卒中不仅具有较高的临床诊断价值,能够提供急性缺血性脑卒中相关动脉阻塞信息,还具有检查方便、安全、用时较短的特点,值得临床推广。

Objective To investigate the screening value of cerebral computer tomography angiography(CTA)for acute ischemic stroke.Method The clinical data of 160 patients with suspected acute ischemic stroke who underwent cerebral CTA examination in Civil Aviation General Hospital from May 2020 to July 2022 were collected.The basic clinical characteristics of the patients were collected,including age,gender,basic medical history,laboratory test results at admission,imaging test results,and onset information.Taking the comprehensive clinical diagnosis result as the gold standard,the diagnostic value of brain CTA for acute ischemic stroke was evaluated.At the same time,its evaluation value to the culprit vessel was analyzed.Result During hospitalization,further clinical comprehensive examination revealed that among 160 suspected acute ischemic stroke patients,127 patients were ultimately diagnosed with acute ischemic stroke and 33 patients were non acute ischemic stroke patients.The sensitivity of brain CTA in the diagnosis of acute ischemic stroke was 97.6%(124/127),the specificity was 93.9%(31/33),the missed diagnosis rate was 2.4%(3/127),the misdiagnosis rate was 6.1%(2/33),the Youden index was 0.916,the positive predictive value was 0.984,the negative predictive value was 0.912,and the Kappa index was 0.906(P<0.01).Conclusion Cerebral CTA not only has high clinical diagnostic value for acute ischemic stroke but also could provide stroke-related arterial obstruction information.Moreover,it has the characteristics of convenient,safe,and short-term inspection,and is worthy of clinical promotion.