颅脑CT血管成像在急性脑梗死患者脑血管狭窄及侧支循环评估中的临床价值

Clinical value of cerebral CT angiography in evaluating cerebrovascular stenosis and collateral circulation in patients with acute cerebral infarction

目的:探讨颅脑CT血管成像(CTA)在急性脑梗死(ACI)患者脑血管狭窄及侧支循环评估中的应用价值。方法:选取2021年5月—2023年5月莒县妇幼保健计划生育服务中心收治的85例ACI患者,均行颅脑CTA、数字减影血管造影(DSA)检查,明确脑血管狭窄、侧支循环状况,并以DSA检查为金标准,分析颅脑CTA诊断ACI患者脑血管狭窄及侧支循环的灵敏度、特异度、准确率、阳性预测值及阴性预测值;并采用Kappa检验验证颅脑CTA诊断ACI患者脑血管狭窄及侧支循环与DSA的一致性。结果:85例ACI患者经DSA检出脑血管狭窄76例,其中颅脑CTA检出脑血管狭窄75例;颅脑CTA诊断ACI患者脑血管狭窄的灵敏度、特异度、准确率、阳性预测值、阴性预测值均较高,Kappa检验显示,颅脑CTA诊断与DSA一致性极好;85例ACI患者经DSA检出侧支循环不良54例,其中颅脑CTA检出侧支循环不良53例;颅脑CTA诊断ACI患者侧支循环的灵敏度、特异度、准确率、阳性预测值、阴性预测值均较高,Kappa检验显示,颅脑CTA诊断与DSA一致性极好。结论:颅脑CTA在ACI患者脑血管狭窄及侧支循环评估中具有较高价值,可明确脑血管狭窄程度及侧支循环情况,且与DSA一致性高,可指导临床治疗。

Objective To investigate the clinical value of craniocerebral CT angiography(CTA)in the assessment of cerebrovascular stenosis and collateral circulation in patients with acute cerebral infarction(ACI).Methods A total of 85 patients with ACI admitted to Juxian maternal and child health and family planning service center from May 2021 to May 2023 were selected as the study objects,all of whom were examined by craniocerebral CTA and digital subtraction angiography(DSA)to identify cerebrovascular stenosis and collateral circulation,and DSA was used as the gold standard.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of craniocerebral CTA in diagnosing cerebrovascular stenosis and collateral circulation in ACI patients were analyzed.Kappa test was used to verify the consistency of craniocerebral CTA in diagnosing cerebrovascular stenosis and collateral circulation in ACI patients with DSA.Results Cerebrovascular stenosis was detected in 76 of 85 ACI patients by DSA,and 75 of them by CTA.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of craniocerebral CTA in diagnosing cerebrovascular stenosis in ACI patients were higher,Kappa test showed that cerebral CTA diagnosis was in good agreement with DSA diagnosis.Testing for collateral circulation among 85 ACI patients,54 cases were detected by DSA,and 53 cases were detected by craniocerebral CTA.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of craniocerebral CTA in diagnosing the collateral circulation of ACI patients were higher,Kappa test showed that cerebral CTA diagnosis was in good agreement with DSA diagnosis.Conclusion Craniocerebral CTA has a high value in the assessment of cerebrovascular stenosis and collateral circulation in ACI patients,which can clarify the degree of cerebrovascular stenosis and collateral circulation,and has a high consistency with DSA,which can guide clinical treatment.