Feasibility of Subtraction Coronary Computed Tomographic Angiography and Influencing Factor Analysis: a Retrospective Study

Objective To investigate the feasibility of subtraction coronary computed tomographic(CT)angiography(SubCCTA)to decline calcium artifacts and improve diagnostic accuracy in the presence of coronary calcification and analyze the factors that influence SubCCTA.Methods A total of 294 patients suspected of having coronary artery diseases underwent coronary computed tomographic angiography(CCTA)and SubCCTA.Coronary stenoses were blindly evaluated by two experienced radiologists,which were compared with invasive coronary angiography(ICA).Multiple statistical indexes were adopted to analyze the value of SubCCTA for the diagnosis of calcium stenoses.Results The diagnosable rate of SubCCTA was 67.2%(n=197),and the non-diagnosable rate was 32.8%(n=97).Using SubCCTA,the false positive rate decreased from 56.5%to 17.4%,and the corresponding diagnostic accuracy was increased from 83.6%to 92.9%.Univariate logistic regression analysis showed that height(OR=1.029,95%CI=1.001–1.058),weight(OR=1.025,95%CI=1.004–1.046),left ventricular size(OR=1.018,95%CI=1.007–1.030),cardiothoracic ratio(OR=39.917,95%CI=1.244–1281.098),the average heart rate(OR=0.866,95%CI=0.836–0.896)and heart rate range(OR=0.882,95%CI=0.853–0.912)might be the factors influencing SubCCTA.Conclusion This study suggested that SubCCTA could help improve diagnostic accuracy in the presence of calcium plaques.Moreover,several factors were discovered for the first time to possibly influence SubCCTA,which will be helpful in improving the subtracted image quality.

Head dual energy-computed tomography angiography versus neuro-digital subtraction angiography

Dual-energy X-ray absorptiometry provides two modes of head computed tomography （CT） angiography scanning： neuro-digital subtraction angiography and dual-energy CT angiography （DE-CTA）. Previous studies have compared image quality, radiation exposure, and bone removal between neuro-digital subtraction angiography and DE-CTA. However, the number of cases was relatively small. The present study examined 300 suspected cases of cerebrovascular disease and observed the methods and duration of post-processing, examination time, and data volume. Results demonstrated similar image quality between the two methods, but lower radiation doses and shorter examination time in DE-CTA. DE-CTA allowed for faster and more stable scanning performance and post-processing methods, facilitating accurate and direct diagnosis of cerebrovascular disease.

Digital subtraction angiography for the analysis of supraaortic vessels: What is its role nowadays?

For about 50 years, angiography represented the only imaging method for studying carotid arteries in order to detect the presence of pathological stenosis due to atherosclerotic plaque. Recently, thanks to the use of non-invasive methods, physicians are able to study and quantify the presence of carotid atherosclerosis in vivo These procedures have enabled the introduction of new concepts: (1) the degree of carotid stenosis is approxi- mate to the volume and extension of carotid plaque; and (2) a set of parameters, easily identifiable by com- puted tomography angiography, magnetic resonance angiogram and ultra-sound echo-color Doppler, are closely linked to the development of ischemic symptoms and can significantly increase the risk of stroke regard- less of the degree of stenosis. In light of these findings vulnerable plaques should be identified early, and the role of Digital Subtraction Angiography which is a purely technical luminal technique should be determined.

Splanchnic vein thrombosis in necrotizing acute pancreatitis: Detection by computed tomographic venography

AIM: To assess the diagnostic accuracy of computed tomographic venography(CTV) for splanchnic vein thrombosis(SVT) detection in necrotizing acute pancreatitis(AP) patients.METHODS:Forty-three patients with necrotizing AP who underwent both CTV and digital subtraction angiography(DSA)within 3 d were analyzed in this retrospective comparative study.All CTV procedures were performed with a dual-source CT scanner.The presence and location of SVT were determined via blinded imaging data analyses.RESULTS:According to the DSA results,17(39.5%)of the total 43 patients had SVT.The sensitivity,specificity,positive and negative predictive values of CTV for SVT detection were 100%(95%CI:77.1%-100%),92.3%(95%CI:73.4%-98.7%),89.5%(95%CI:65.5%-98.2%)and 100%(95%CI:82.8%-100%),respectively.CONCLUSION:CTV is an effective examination for SVT detection in patients with necrotizing AP with high positive and negative predictive values.

Intracranial aneurysm with neck indistinguishable from surrounding artery branches by cerebral angiography

The aim of this study is to examine morphology of intracranial aneurysm with neck indistinguishable from surrounding artery branches by cerebral angiography and discuss whether such aneurysms can be treated by interventional embolization. 6 patients who had not been treated by embolization due to irregular wide-necked aneurysms indistinguishable from surrounding artery branches by cerebral angiography received craniotomy for aneurysm clipping. The operations succeeded. Morphologically, neck width and location of the aneurysms were carefully observed and photographed from different directions and multi-angles during operation. The intraoperative findings were compared with the preoperative CTA and DSA images. Walls of the 6 patients’ aneurysms tightly clung to or adhered to surrounding branches and oppressed the branches into arcs, similar to the aneurysm walls in shape, and arterial branches and aneurysm walls suffered from segmental adhesion. In addition, abnormalities of communicating arteries to vary degrees were observed in 4 patients. However, after successful surgical clipping, it was revealed that the aneurysms would have been better treated by embolization since they are basically saccular aneurysms with regular sizes. Deformations in preoperative angiography may be due to anatomical variations of surrounding vessels near the aneurysms, aneurysm wall oppression or incomplete adhesion of surrounding arterial branches. Such deformations can be recognized by careful observation in preoperative angiography from different directions and multi-angles.

Acquired renal arteriovenous malformation:the diagnostic value of three-dimensional multidetector-row computed tomography

Objective To evaluate the diagnostic value of three-dimensional multidetector-row computed tomogra- phy （MDCT） in detecting acquired renal arteriovenous malformation （RAVM） and to compare its perfor- mance with that of ultrasonography and digital subtraction angiography （DSA）. Methods The institutional review board approved this retrospective study and written informed consent was obtained from all patients before examination. All 14 patients with acquired RAVM underwent MDCT, including cortical and medullary phase enhancement angiography and three-dimensional （3D） reconstruc- tion. Five and nine patients were further examined and their diagnoses confirmed by DSA and surgery, respectively. The MDCT images, including 3D reconstructions, were analyzed for RAVM independently and in consensus by two observers using a workstation. Results Among the 14 patients with acquired RAVM, 12 with maximum lesion diameter 〉 10 mm, and one with a maximum lesion diameter between 5 and 10 ram, were correctly diagnosed with MDCT angiog- raphy. Among these patients, four diagnoses were confirmed by DSA. One patient with a lesion 5-10 mm in diameter was misdiagnosed with a renal aneurysm by MDCT angiography. The other one with the maxi- mum diameter of the lesion between 5 mm and 10 mm was misdiagnosed as renal aneurysm with MDCT angiography, which was diagnosed as renal arteriovenous malformation with DSA. Among 14 lesions in 14 patients, eight and six originated in the left and right kidney, respectively. Conclusion MDCT angiography can accurately diagnose RAVM and improve our understanding of the disease, which will allow clinicians to provide better care.

基于深度学习的图像重建算法在下肢动脉病变CTA诊断中的研究

目的 探讨基于深度学习的图像重建算法对下肢动脉病变CT血管成像(Computed Tomography Angiography,CTA)的诊断价值。方法 回顾性收集2021年6月至2022年2月于我院就诊的51例下肢动脉狭窄或闭塞患者的CTA检查资料(65条下肢动脉)。分别基于深度学习的图像重建(Deep Learning Image Reconstruction,DLIR)算法和混合迭代重建(Hybrid Iterative Reconstruction,HIR)算法对CTA图像进行重建,以HIR法为参照进行质量评估;两位医师在不同重建算法下对血管狭窄的部位和程度进行评估,并采用Kappa检验观察者间一致性;以数字减影血管造影作为“金标准”比较HIR法和DLIR法诊断下肢动脉中度和重度狭窄的效能。结果与HIR法相比,DLIR法图像质量的噪声显著降低(Z膝上动脉=8.36,Z膝下动脉=9.46,Z足背动脉=7.19,均P<0.001),信噪比(Z膝上动脉=-7.32,Z膝下动脉=-7.91,Z足背动脉=-8.45,P<0.001)及对比噪声比(Z膝上动脉=-8.66,Z膝下动脉=-9.21,Z足背动脉=-8.52,均P<0.001)显著提高。DLIR法对动脉狭窄或闭塞程度的识别和评估均显示出更高的观察者间一致性(Kappa=0.86)。与HIR法相比,DLIR法的图像对膝下动脉重度狭窄的敏感度(72.2%vs.94.4%)、特异性(78.7%vs.95.7%),足背动脉中度狭窄的特异性(86.0%vs.97.7%)及重度狭窄的敏感度(50.0%vs.87.5%)均显著提高(P<0.05)。结论 DLIR算法可有效改善下肢动脉的CTA图像质量,并获得更优的诊断效能。

CT及磁共振血管成像诊断颅内动脉瘤的价值

目的分析CT血管成像(computed tomography angiography,CTA)、磁共振血管成像(magnetic resonance angiography,MRA)诊断颅内动脉瘤的价值。方法选取2020年6月-2023年1月广西贵港市人民医院90例疑似颅内动脉瘤患者,均接受CAT及MRA检查,将数字减影血管成像(digital subtraction angiography,DSA)或手术病理学检查结果作为金标准,比较两种方法检出情况、测量颅内动脉瘤瘤体直径与瘤颈宽度、对比不同大小的颅内动脉瘤检出情况,分析两种方法单独及联合诊断颅内动脉瘤的价值。结果90例疑似颅内动脉瘤患者经CTA检查后诊出64例单发颅内动脉瘤,经MRA检查后诊出61例单发颅内动脉瘤,两种方法检出情况比较无明显差异(P>0.05);当瘤体<3 mm时CTA检出率93.33%高于MRA 60.00%(P<0.05);CTA诊断颅内动脉瘤的准确率83.33%、敏感度83.56%、特异度82.35%、Kappa值=0.548;MRA诊断颅内动脉瘤的准确率82.22%、敏感度80.82%、特异度88.24%、Kappa值=0.543;CTA联合MRA诊断颅内动脉瘤的准确率95.56%、敏感度95.89%、特异度94.12%、Kappa值=0.861。结论CTA与MRA均可用于诊断颅内动脉瘤,其中CTA可明显提高<3 mm的微小颅内动脉瘤诊出率,但联合应用时的敏感度更高。

CTA与DSA评估慢性肢体威胁性缺血患者全球肢体解剖学分期系统分期的一致性分析

目的分析CTA与DSA在评估慢性肢体威胁性缺血(CLTI)患者全球肢体解剖学分期系统(GLASS)分期中的一致性。方法 回顾性分析2017年1月至2020年12月西安交通大学第一附属医院收治的CLTI患者临床资料。以DSA评估结果为金标准,分析CTA与DSA评估GLASS分期的一致性。结果 CTA评估GLASS评分与DSA具很强的一致性,其中两者评估股腘动脉段评分的加权Kappa系数为0.798(95%CI=0.722~0.873,P<0.01),评估膝下动脉段评分的加权Kappa系数为0.785(95%CI=0.725~0.845,P<0.01),评估GLASS整体评分的加权Kappa系数为0.832(95%CI=0.752~0.911,P<0.01),均显示出很强的一致性。结论 下肢动脉CTA检查可准确评估CLTI患者靶病变GLASS评分和分期,有助于下肢动脉硬化闭塞症诊断及血运重建技术难度评估。

多层螺旋CT仿真内窥镜在颈动脉狭窄中的诊断价值

目的:探讨多层螺旋CT仿真内窥镜技术(computed tomography virtual endoscopy,CTVE)在颈动脉狭窄中的诊断价值。方法:回顾性分析2021年1月—2023年3月期间汕头大学医学院第一附属医院收治的60例颈动脉狭窄患者的临床资料,其中男性49例,女性11例,年龄46~85(66±8)岁。所有患者均行颈部CT血管造影(computed tomography angiography,CTA)检查、颈部血管超声(cervical vascular ultrasound,CVUS)检查及数字减影血管造影(digital subtraction angiography,DSA)检查,其中CTA检查后进行CTVE成像处理。以DSA诊断结果为金标准,分析CTA联合CTVE及CVUS诊断颈动脉狭窄程度的一致性。结果:以DSA诊断结果为金标准,CTA联合CTVE及CVUS诊断颈动脉狭窄的Kappa值分别为0.764和0.756,均具有较好的一致性。CTA联合CTVE诊断不同程度颈动脉狭窄的Kappa值分别为0.702(轻度狭窄)、0.648(中度狭窄)、0.905(重度狭窄)、0.959(闭塞)。结论:CTVE在颈动脉狭窄中具有较好的诊断价值,尤其在对于颈动脉重度狭窄或闭塞的诊断中,其优势更加突出。

CTA和DSA对Bühler弓检出率的Meta分析

目的评价CTA和DSA对Bühler弓(arc of Bühler,AOB)的检出率和临床意义。方法检索PubMed、Web of Science、Scopus、Embase、Google Scholar、CBM、CNKI、WanFang、VIP、Baidu Scholar数据库,纳入AOB相关的文献,采用Stata 17.0软件进行Meta分析。结果共计纳入11篇文献,包括研究对象3837例(含65例AOB)。AOB的总检出率为1.9%(0.8%~3.2%),CTA显示AOB的总检出率为2.0%(0.5%~4.3%),DSA显示AOB的总检出率为1.8%(0.5%~3.9%)。结论AOB是一种罕见的解剖学变异,在实施相关腹部手术时应考虑到AOB的存在,以免造成操作困难、腹腔脏器缺血或出血等并发症。

CTA在急诊骨盆骨折出血中对血管栓塞治疗的指导价值

目的探讨骨盆CT血管造影(computed tomography angiography,CTA)在急诊骨盆骨折出血中对患者行血管栓塞治疗的指导价值。方法选取2019年6月至2023年6月于绍兴第二医院医共体总院治疗的67例急诊骨盆骨折出血患者,所有患者均行CTA和数字减影血管造影(digital subtraction angiography,DSA)检查,以DSA检查结果为金标准评价CTA的应用价值。结果CTA检查发现66例患者血管损伤,出血或损伤血管167支;DSA检查发现66例患者血管损伤,出血或损伤血管186支。CTA对阳性病例的检出率为97.0%,对血管损伤的检出率为82.8%。CTA检查血管损伤的阳性预测值为92.2%,阴性预测值为97.1%,敏感度为82.8%,特异性为98.8%。结论CTA检查对急诊骨盆骨折出血的诊断结果与DSA高度一致,可为患者治疗方案的制定提供重要参考依据。

基于CTA和DSA评价膈下动脉解剖学变异和临床相关性:一项系统评价和Meta分析

目的:评价基于CT血管成像(CTA)和数字减影血管造影(DSA)的膈下动脉(IPA)解剖学变异的发生率与临床相关性。方法:系统检索PubMed、Web of Science、Scopus、Embase、Google Scholar、CBM、CNKI、WanFang、VIP和Baidu Scholar等数据库,纳入与左、右膈下动脉(LIPA和RIPA)相关的文献,并采用Stata 17.0软件进行Meta分析。结果:共纳入19篇文献,包括6754例患者。IPA共干和单独起源的汇总发生率分别为29.4%(95%CI:24.8%~34.2%)和70.6%(95%CI:65.8%~75.2%);IPA共干以起源于腹主动脉和腹腔干最为常见,汇总发生率分别为48.2%(95%CI:42.4%~54.1%)和49.0%(95%CI:43.3%~54.7%);RIPA单独起源以腹主动脉和腹腔干最为常见,汇总发生率分别为40.9%(95%CI:36.7%~45.3%)和34.8%(95%CI:30.7%~38.9%);LIPA单独起源以腹腔干和腹主动脉最为常见,汇总发生率分别为58.5%(95%CI:53.2%~63.7%)和32.6%(95%CI:27.3%~38.1%)。结论:IPA的起源变异十分丰富,熟悉IPA的起源变异对介入放射学、胃肠病学、外科学和创伤学医师具有十分重要的临床意义。

自发性蛛网膜下腔出血首次血管造影阴性患者诊治进展

自发性蛛网膜下腔出血(spontaneous subarachnoid hemorrhage,sSAH)是神经外科常见的危急重症之一,目前仍有较高的致死致残率。针对该类患者,尽快完善计算机断层扫描血管造影(computed tomographic angiography,CTA)或数字减影脑血管造影(digital subtraction angiography,DSA)检查明确出血原因及部位,并根据确定的原因尽快采取手术治疗,这对改善患者预后显得尤为重要。然而,有部分患者首次血管造影存在假阴性,其原因包括多方面,如中脑周围蛛网膜下腔出血、微小动脉瘤、血栓性动脉瘤、颅内血管畸形、脊髓血管畸形以及阅片者经验等。首次造影阴性的患者必须复查,尤其是针对那些发病后头颅CT平扫高度怀疑动脉瘤患者,复查建议在早期(<2周)及中期(2~8周)进行,同时需提高对微小血管病变的警惕性及识别能力,借助于最新影像学技术,提高对病因的首次检出率。

CCTA与DSA在诊断冠状动脉斑块的临床应用价值

目的:探讨冠状动脉CT血管造影(CCTA)与数字减影血管造影(DSA)在诊断冠状动脉斑块中的应用价值。方法:回顾性选取2020年1月—2023年5月本院诊断为冠心病的患者64例,均行CCTA和DSA检查,以DSA为金标准,分析比较CCTA和DSA对冠状动脉斑块检出率及性质和狭窄程度的诊断价值。结果:64例患者经DSA检出冠状动脉斑块58例(90.63%),其中轻度狭窄21例,中度狭窄23例,重度狭窄14例,无法有效判断动脉斑块性质。经CCTA检出冠状动脉斑块55例(85.94%),其中轻度狭窄19例,中度狭窄22例,重度狭窄14例,12例非钙化斑块、13例混合斑块和30例钙化斑块。以DSA为金标准,CCTA诊断冠状动脉斑块的灵敏度为94.83%、特异度为83.33%、准确度为93.75%、阳性预测值为98.21%、阴性预测值为62.50%、Kappa系数值为0.680。CCTA和DSA在冠状动脉狭窄程度的检出率比较上均无差异(P>0.05)。轻度狭窄者钙化斑块发生率高于中度和重度狭窄者,非钙化、混合斑块发生率低于中度和重度者(P<0.05)。结论:CCTA与DSA在诊断冠状动脉斑块及其狭窄程度上具有高度一致性,但CCTA较DSA对斑块性质的诊断价值更高。

Noninvasive three-dimensional computed tomographic angiography in preoperative detection of intracranial arteriovenous malformations

Obejctive To assess the value of noninvasive three dimensional computed tomographic angiography (3D CTA) in preoperative detection of intracranial arteriovenous malformations (AVMs) Methods A prospective evaluation at a single institute over a 2 year period included 23 patients suspected of intracranial AVMs All patients underwent 3D CTA and digital subtraction angiography (DSA) Results from both procedures were compared Results 3D CTA imaging provided excellent visualization of intracranial AVMs The false positive error and false negative error were zero in our sample The details of arterial supply (numerical measure, orientation, caliber and routing) and vascular nidus (size, morphosis and location) provided by 3D CTA images were the same as DSA and the details of venous drainage were an approximate match Additionally, 3D CTA can depict tridimensional anatomical information for AVMs and their relationship to adjacent structures, a function not possible with DSA This assisted the surgeons in making better surgical planning and reduced trauma As a non invasive course, there were no related complications in the course of 3D CTA processing Conclusions DSA is still regarded as the gold standard for intracranial AVMs detection The modality of 3D CTA is accurate, noninvasive, nearly risk free and low price; we could routinely use it instead of or as a supplement to DSA, in the preoperative detection of suspected intracranial AVMs and postoperative radiological follow up 3D CTA adds tridimensional aspect and assists the surgeon in a the more accurate therapeutic scheme Preliminary data suggest that 3D CTA is playing a favorable role in the assessment of patients with intracranial AVMs

CTA与多普勒超声检查在下肢动脉硬化闭塞症诊断中的对比分析

目的探讨CT血管造影(CTA)与多普勒超声(DUS)检查在下肢动脉硬化性闭塞症(ASO)中的诊断效能。方法选取我院经数字减影血管造影(DSA)检查并接受腔内血管成形术治疗的80例ASO患者。以DSA作为金标准,对比患者术前CTA及DUS诊断ASO的效能及一致性。结果CTA对全段下肢动脉及髂动脉段≥50%血管狭窄及闭塞的检出率分别较DUS高4.89%(P=0.002)和2.29%(P=0.007)。CTA对下肢全段≥50%血管狭窄及腘上动脉段管腔闭塞的诊断效能及一致性均高于DUS(敏感性:81.47%~96.84%vs 80.35%~89.66%;特异性82.39%~90.75%vs 82.16%~87.25%;Kappa值:0.82~0.98 vs 0.79~0.94),而对腘下动脉段血管闭塞的评估表现不及DUS(敏感性:77.83%vs 78.49%;特异性:72.15%vs 79.28%;Kappa值:0.72 vs 0.76)。结论CTA对ASO患者的血管评估效能总体优于DUS,而对于腘下动脉段血管重度狭窄及闭塞仍需联合DUS综合评估,以制定最佳临床治疗方案。

3D-数字减影血管造影联合Innova-计算机断层扫描功能在颅内支架辅助动脉瘤弹簧圈栓塞术后复查中的应用

目的探讨颅内支架辅助动脉瘤弹簧圈栓塞术复查时3D-数字减影血管造影(DSA)联合Innova-计算机断层扫描(CT)的影像学表现对患者术后评估的影响。方法收集2021年1月至2022年12月安徽医科大学第三临床学院/合肥市第三人民医院收治的104例颅内支架辅助动脉瘤弹簧圈栓塞术后复查患者的临床资料,所有患者均行3D-DSA和Innova-CT扫描,由两名神经介入医师对重建后的图像从术后颅内动脉瘤栓塞程度、支架打开情况及重建图像的质量方面进行评估。结果104例颅内支架辅助动脉瘤弹簧圈栓塞术后复查患者均通过3D-DSA联合Innova-CT检查获得了精确、全面的术后评估。两名神经介入医师对术后颅内动脉瘤栓塞程度、颅内动脉瘤支架打开情况的评估分级比较,差异均有统计学意义(P﹤0.05)。Innova-CT图像支架金属丝显影清晰,弹簧圈金属伪影不明显,图像质量显著提高。3D-DSA和Innova-CT的图像质量比较,差异有统计学意义(P﹤0.05)。Kappa检验结果显示,两名神经介入医师评估术后颅内动脉瘤栓塞程度、支架打开情况、铂金标记点、镍钛金属丝、弹簧圈金属伪影的Kappa值均≥0.75,具有较高的一致性。结论Innova-CT在颅内支架辅助动脉瘤弹簧圈栓塞术后复查中,特别是在支架打开情况的显示方面具有独特的优势,可作为3D-DSA的补充检查方式,使检查更加完善,对颅内支架辅助动脉瘤弹簧圈栓塞术后复查情况的评估具有指导作用。

数字减影血管造影和头颈部CT血管造影对颅内动脉瘤的诊断价值

目的 探讨数字减影血管造影和头颈部CT血管造影对68例颅内动脉瘤患者的诊断价值。方法 本研究中68例颅内动脉瘤均来源于河南科技大学第一附属医院,选取时间为2021年8月到2023年8月,进行回顾性分析,所有患者均进行数字减影血管造影和头颈部CT血管造影检查。将手术结果作为金标准,比较数字减影血管造影和头颈部CT血管造影检查方法的诊断符合率,比较2种检查方法对不同部位动脉瘤显示情况,比较2种检查方法对不同大小动脉瘤的检出情况。结果 头颈部CT血管造影检查颅内动脉瘤的诊断符合率为93%,数字减影血管造影检查颅内动脉瘤的诊断符合率为94%,经对比,2种方法的诊断符合率对比,差异无统计学意义(P>0.05);头颈部CT血管造影、数字减影血管造影对后交通动脉、前交通动脉、大脑轻动脉等部位的检出率比较,差异均无统计学意义(均P>0.05);手术结果证实68例患者共有80个动脉瘤,其中>3 mm的有42个,≤3 mm的有38个,2种检查方法诊断>3 mm动脉瘤的检出情况经对比,差异无统计学意义(P>0.05),针对≤3 mm的动脉瘤,数字减影血管造影的检出率比头颈部CT血管造影高,差异有统计学意义(P<0.05),头颈部CT血管造影对>3 mm动脉瘤的检出率比≤3 mm的检查率高,差异有统计学意义(P<0.05),数字减影血管造影对>3 mm、≤3 mm的检出率经对比,差异无统计学意义(P>0.05)。结论 在对颅内动脉瘤患者的诊断中,采用数字减影血管造影和头颈部CT血管造影检查各有优劣势,其中头颈部CT血管造影检查可对患者早期确诊,但该方法无法对微小、特殊位置的动脉瘤准确诊断,联合数字减影血管造影可提高诊断准确率,从而为临床医生制定治疗方案提供一定的参考依据。

多层螺旋CT冠状动脉造影与数字减影血管造影诊断经皮冠状动脉介入术术后再狭窄的效果分析

目的 探讨分析多层螺旋CT冠状动脉造影与数字减影血管造影(DSA)诊断经皮冠状动脉介入术(PCI)术后再狭窄中的效果。方法 选择我院收治的78例PCI术患者作为本次研究对象,纳入时间为2021年8月至2023年8月,患者均行多层螺旋CT冠状动脉造影与DSA诊断,以DSA诊断结果为金标准,针对不同诊断方式PCI术后再狭窄情况等展开分析。结果 78例PCI术患者支架共计160枚,经多层螺旋CT冠状动脉造影诊断显示术后出现狭窄30枚(18.8%),未出现狭窄130枚(81.2%),DSA诊断结果显示出现狭窄34枚(21.2%),未出现狭窄126枚(78.8%);PCI术后再狭窄的诊断中,多层螺旋CT冠状动脉造影特异度98.4%,灵敏度82.4%,阳性预测率93.3%,阴性预测率95.4%。结论 多层螺旋CT冠状动脉造影对于PCI术后再狭窄诊断结果同DSA诊断近似,能够较好预测PCI术后再狭窄情况,充分发挥辅助作用,临床将以上2种诊断方法结合应用,不仅可及时发现PCI术后再狭窄情况,而且可为相关治疗工作提供科学依据,同时还可作为筛查冠心病、PCI术后随访工具使用。