摘要
目的:探讨头颈CT血管成像(CTA)对急性缺血性脑卒中患者侧支循环及动脉狭窄的诊断价值.方法:选取2017年1月—2019年1月我院收治的急性缺血性脑卒中患者40例,行头颈CTA及数字减影血管造影(DSA)检查,并将DSA检查结果作为金标准,比较CTA检测急性缺血性脑卒中侧支循环及动脉狭窄的准确性.结果:40例患者中,CTA检查结果中共出现361处狭窄,DSA检查结果中共出现381处狭窄,CTA与DSA的诊断符合率为94.8%.CTA与DSA对于血管狭窄的检出率以及狭窄程度的诊断,差异无统计学意义(P>0.05).DSA检查发现32例患者有侧支循环形成,CTA检查发现31例患者有侧支循环形成,差异无统计学意义(P>0.05);在CTA检查结果中,侧支循环代偿差的患者在入院及出院时的神经功能评分高于代偿良好的患者;出院90 d后,侧支循环代偿差的患者神经功能评分高于代偿良好的患者,差异均有统计学意义(P<0.05).采用ROC曲线评估CTA对脑卒中患者动脉狭窄及侧支循环的诊断效能,检出动脉狭窄的曲线下面积(AUC)为0.862,敏感度和特异度分别为88.57%和80.00%,检出侧支循环的AUC为0.834,敏感度和特异度分别为93.55%和66.67%.结论:CTA在急性缺血性脑卒中患者头颈血管的狭窄程度以及侧支循环的诊断中能够提供较好的图像质量,具有较高的临床诊断价值,可作为急性缺血性脑卒中患者头颈血管检查的重要方法.
Objective:To investigate the diagnostic value of head and neck computed tomography angiography(CTA)for collateral circulation and arterial stenosis in acute ischemic stroke.Methods:This study enrolled 40 patients with acute ischemic strokein to our hospital from January 2017 to January 2019.Head and neck CTA and digital subtraction angiography(DSA)were performed in all patients.DSA results were treated as the gold standard.Comparison between CTA results and DSA results were performed to determine the accuracy of CTA in detecting collateral circulation and arterial stenosis in acute ischemic stroke.The ROC curve was used to evaluate the diagnostic efficacy of CTA in the diagnosis of collateral circulation and arterial stenosis in stroke patients.Results:In CTA results,361 stenosis were detected,while in DSA results,381 stenosis were detected.The consistency of CTA and DSA results was 94.8%.There were no significant differences between CTA and DSA in the detection of vascular stenosis and the diagnosis of stenosis degree(P>0.05).In DSA,32 patients had collateral circulation,while in CTA,31 patients had collateral circulation.It was showed no significant difference(P>0.05).In CTA results,the neurological function scores were higher in the patients with poor collateral circulation compensation compared to those with good collateral circulation compensation in admission and discharge(P<0.05).After 90 days of discharge,the neurological function scores of patients with poor collateral circulation compensation were higher than those with good collateral circulation compensation(P<0.05).The AUC of arterial stenosis was 0.862,the sensitivity and specificity were 88.57% and 80.00%.The AUC of collateral circulation was 0.834,the sensitivity and specificity were 93.55% and 66.67%.Conclusion:Head and neck CTA has high clinical diagnostic value in vascular stenosis and collateral circulation in acute ischemic stroke,which can be used as an important method for the clinical diagnosis of head and neck vascular stenosis and collateral circulation in acute ischemic stroke.
作者
余燕武
江敏
陆国云
YU Yan-wu;JIANG Min;LU Guo-yun(Ningde Municipal Hospital,Ningde Normal University,Ningde Fujian 352100,China)
出处
《中国临床医学影像杂志》
CAS
2020年第12期862-866,共5页
Journal of China Clinic Medical Imaging
基金
宁德市医技提升科研项目(2017519)。
