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CT血管造影(CTA)检测颈动脉狭窄可作为评价中风和短暂性脑缺血发作(TIA)的首选方法 被引量:1
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作者 Josephson S.A. Bryant S.O. +2 位作者 Mak H.K. w.s. smith 邓剑平 《世界核心医学期刊文摘(神经病学分册)》 2005年第1期47-47,共1页
Background: Imaging of the carotid arteries is important for the evaluation of patients with ischemic stroke or TIA. CT angiography (CTA) of the head and neck is readily avai lable and can be part of the routine imagi... Background: Imaging of the carotid arteries is important for the evaluation of patients with ischemic stroke or TIA. CT angiography (CTA) of the head and neck is readily avai lable and can be part of the routine imaging of stroke patients. To evaluate the accuracy of CTA, the authors compared the degree of stenosis found using CTA with digital subtraction angiography (DSA) in consecutive patients during a 3 year period. Methods: The authors included all patients with interpretable CTA and DSA of the cervical carotid arteries from April 2000 to November 2002 at a single academic medical center. This yielded a total of 81 vessels. Stenosis on CTA of the internal carotid artery was measured in the axial plane at the point of maximum stenosis and referenced to the distal cervical internal carotid by two blinded readers. Two blinded readers measured stenosis from the DSA using the North American Symptomatic Carotid Endarterectomy Trial method. Results: Using a 70% cutoff value for stenosis, CTA and DSA were in agreement in 78 of 81 (96% ; 95% CI, 90 to 99% ) vessels. CTA was 100% sensitive (n = 5) and 63% specific (95% CI, 25 to 88% ), and the negative predictive value of a CTA demonstrating <70% stenosis was 100% (n = 73). Conclusions: In this consecutive series of patients with CT angiography of the neck and digital subtraction angiography, the authors found that CT angiography has a high sensitivity and high negative predictive value for carotid disease. CT angiography appears to be an excellent screening test for internal carotid artery stenosis, and the authors advocate its use for the initial imaging of patients with suspected stroke or TIA. 展开更多
关键词 血管造影 颈动脉狭窄 TIA CTA 血管成像 阴性预测值 血管狭窄程度 狭窄部位 影像学检查 颈部血管
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