多时相CTA联合彩色编码评估脑中小血管闭塞的临床价值探讨

Clinical value of multi-temporal CTA combined with color coding in evaluating small and medium-sized vascular occlusion in the brain

目的:探讨多时相CTA(mCTA)联合彩色编码在检测脑中小血管闭塞中的临床价值。方法:回顾性分析2019年6月—2022年9月因怀疑急性脑卒中来我院就诊的82例患者的影像资料,患者均行mCTA检查。对4名放射科医生按职称分组,A组为2名主治及以下医师,B组为2名副主任及以上医师。比较两组医师阅片做出最终诊断时长、报告医师可信度水平及定量评估诊断准确性有无差异。结果:使用彩色编码mCTA后,阅片时间显著缩短(P=0.005),诊断可信度增加(P=0.012),敏感性显著增加(P=0.001),特异性显著增加(P=0.027)。常规CTA时,B组医师比A组医师敏感性更高(P<0.001);使用彩色编码mCTA后,A组医师和B组医师敏感性分别增加了8.6%(P=0.62)和5.6%(P=0.41),两组之间比较无显著差异(P=0.61)。结论:使用彩色编码mCTA可显著提高诊断脑中小血管闭塞的敏感性,明显提高低年资医生的诊断准确率,可作为评估脑中小血管闭塞性脑卒中的常规检查方法。

Objective:To investigate the clinical value of multitemporal CTA(mCTA)combined with colour coding in detecting small and medium-sized vessel occlusions in the brain.Methods:The imaging data of 82 patients with suspected acute stroke who came to our hospital from June 2019 to September 2022 were retrospectively analyzed.All patients underwent mCTA examination.Four radiologists were divided into two groups according to their professional titles.Group A consisted of two attending physicians and below,and Group B consisted of two deputy chief physicians and above.The final diagnosis time,reliability level of reporting physicians and quantitative evaluation of the diagnostic accuracy were compared between two groups of physicians.Results:The use of colour-coded mCTA resulted in a significant reduction in review time(P=0.005),an increase in diagnostic reliability(P=0.012),a significant increase in sensitivity(P=0.001)and a significant increase in specificity(P=0.027).Spiral CTA was more sensitive for physicians in group B than in group A(P0.001).The use of colour-coded mCTA increased the sensitivity by 8.6%(P=0.62)and 5.6%(P=0.41)for group A and B physicians,respectively,eliminating a significant difference between the two groups(P=0.61).Conclusions:The use of colour-coded mCTA can significantly improve the sensitivity of diagnosing small and medium-sized vessel occlusion in the brain,significantly increase the diagnostic accuracy for junior physicians,and may be routinely used as a screening test for the assessment of small and medium-sized vessel oc-clusive strokes in the brain.