摘要
目的探讨计算机断层扫描血管造影(CTA)对颈动脉狭窄程度的评估价值。方法收集2019年1月至2021年12月攀枝花学院附属医院收治的97例颈动脉狭窄患者的临床资料,以数字减影血管造影(DSA)检查结果为金标准,分析术前CTA与DSA图像质量评分的一致性及对颈动脉狭窄程度诊断效能的一致性,计算其对颈动脉轻度狭窄、重度狭窄、完全闭塞的诊断效能,对比两种检查的图像质量。重度狭窄、完全闭塞患者接受后续手术治疗,以手术病理学检查结果为金标准,分析术前CTA检查对颈动脉粥样硬化斑块性质的诊断价值。结果Kappa一致性检验结果显示,术前CTA检查的图像质量评分、对颈动脉狭窄程度的诊断效能与术前DSA检查结果均具有较高的一致性(Kappa=0.972、0.849,P<0.05)。术前CTA检查诊断颈动脉轻度狭窄的灵敏度为100%,特异度为94.51%,准确度为94.85%;诊断颈动脉重度狭窄、完全闭塞的灵敏度为100%,特异度为98.41%,准确度为98.97%。术前CTA检查对颈动脉轻度狭窄及重度狭窄、完全闭塞的诊断效能均与DSA检查具有较高的一致性(Kappa=0.680、0.978,P<0.05)。术前CTA检查与病理学检查方法对颈动脉斑块性质的诊断结果具有较好的一致性(Kappa=0.931,P<0.05)。结论CTA检查对颈动脉狭窄程度具有较高的诊断价值,能够为颈动脉狭窄治疗方案的制定提供必要参考,并可于术前为颈动脉粥样硬化斑块的性质提供较为准确的评估。
Objective To investigate the value of computed tomography angiography(CTA)in the degree of carotid artery stenosis.Method Clinical data of 97 patients with carotid artery stenosis admitted in Panzhihua University Affiliated Hospital from January 2019 to December 2021 were collected.By using digital subtraction angiography(DSA)as the gold standard,the consistency of image quality scoring and diagnostic efficacy of carotid artery stenosis between preoperative CTA and DSA were analyzed to calculate the diagnostic efficacy of mild and severe carotid artery stenosis and occlusion,and to compare the image quality of two methods.Severe and occlusive patients received subsequent surgical treatment,and the diagnostic value of preoperative CTA on the nature of carotid atherosclerotic plaque was compared using surgical pathology as the gold standard.Result The Kappa test showed that the image quality scoring and diagnostic efficiency for degree of carotid artery stenosis by preoperative CTA had higher consistency with preoperative DSA(Kappa=0.972,0.849,P<0.05).The sensitivity,specificity,and accuracy of preoperative CTA in diagnosing mild degree of carotid artery stenosis were 100%,94.51%,94.85%,and in diagnosing severe stenosis and occlusion were 100%,98.41%,98.97%,respectively.Preoperative CTA in the diagnosis of mild and severe carotid artery stenosis and occlusion were consistent with those of DSA(Kappa=0.680,0.978,P<0.05).There was high consistency for results of preoperative plaque properties assessed by CTA and surgical pathology(Kappa=0.931,P<0.05).Conclusion CTA has a high diagnostic value for the degree of carotid artery stenosis,which can provide necessary reference for the treatment plan of carotid artery stenosis,and provide more accurate assessment for the nature of carotid atherosclerotic plaque before surgery.
作者
符艳梅
周军
彭川
Fu Yanmei;Zhou Jun;Peng Chuan(Medical Imaging Center,Panzhihua University Affiliated Hospital,Panzhihua 617000,Sichuan,China;Department of General Surgery,Panzhihua University Affiliated Hospital,Panzhihua 617000,Sichuan,China)
出处
《血管与腔内血管外科杂志》
2022年第6期734-738,763,共6页
Journal of Vascular and Endovascular Surgery
