摘要
目的探讨颈动脉斑块超声与计算机断层扫描血管造影(CTA)评估缺血性脑卒中(ICS)患者颈动脉粥样硬化(CAS)的价值。方法回顾性选取本院2022年1月~2023年12月收治的125例ICS患者为研究对象,所有患者均行数字减影血管造影(DSA)、CTA、颈动脉斑块超声检查。以DSA检查为“金标准”,比较颈动脉斑块超声、CTA诊断ICS患者CAS斑块性质的诊断价值。结果以DSA检查为金标准,结果显示,125例ICS患者中,77例患者为易损斑块(61.60%,77/125),48例患者为稳定斑块(38.40%,48/125);43例患者为颈动脉轻度狭窄(34.40%,43/125),62例患者为颈动脉中度狭窄(49.60%,62/125),20例患者为颈动脉重度狭窄(16.00%,20/125)。CAS斑块多位于颈总动脉分叉处及颈动脉球部,且斑块信号不一。颈动脉斑块超声诊断76例ICS患者为易损斑块(60.80%,76/125),49例ICS患者为稳定斑块(39.20%,49/125);易损斑块患者颈动脉重度狭窄、纤维帽不完整、斑块低回声占比均高于稳定斑块患者,差异有统计学意义(P<0.05);CTA诊断74例ICS患者为易损斑块(59.20%,74/125),51例ICS患者为稳定斑块(40.80%,51/125);颈动脉斑块超声鉴别诊断ICS患者CAS斑块性质的准确率、敏感性、特异性、阳性预测值、阴性预测值及kappa值均显著高于CTA。结论相比CTA,颈动脉斑块超声对于ICS患者CAS斑块性质的诊断效能较高,具有一定临床应用价值。
Objective To explore the value of carotid artery plaque ultrasound and computed tomography angiography(CTA)in evaluating carotid artery atherosclerosis(CAS)in patients with ischemic stroke(ICS).MethodsA total of 125 ICS patients admitted to our hospital from January 2022 to December 2023 were retrospectively selected as the research subjects.All patients underwent digital subtraction angiography(DSA),CTA,and carotid artery plaque ultrasound examinations.Taking DSA examination as the"gold standard",the diagnostic value of carotid artery plaque ultrasound and CTA in diagnosing the nature of CAS plaques in ICS patients was compared.Results Taking DSA examination as the gold standard,the results showed that among 125 ICS patients,77 patients had vulnerable plaques(61.60%,77/125),and 48 patients had stable plaques(38.40%,48/125).Vulnerable plaques were defined as plaques with an incomplete fibrous cap or mainly hypoechoic plaques.Forty-three patients had mild carotid artery stenosis(34.40%,43/125),62 patients had moderate carotid artery stenosis(49.60%,62/125),and 20 patients had severe carotid artery stenosis(16.00%,20/125).CAS plaques were mostly located at the bifurcation of the common carotid artery and the carotid bulb,and the plaque signals were inconsistent,showing hypoechoic or isoechoic.Carotid artery plaque ultrasound diagnosed 76 ICS patients as having vulnerable plaques(60.80%,76/125),and 49 ICS patients as having stable plaques(39.20%,49/125).The proportions of severe carotid artery stenosis,incomplete fibrous cap,and hypoechoic plaques in patients with vulnerable plaques were all higher than those in patients with stable plaques,and the differences were statistically significant(P<0.05).CTA diagnosed 74 ICS patients as having vulnerable plaques(59.20%,74/125),and 51 ICS patients as having stable plaques(40.80%,51/125).The accuracy,sensitivity,specificity,positive predictive value,negative predictive value,and kappa value of carotid artery plaque ultrasound in the differential diagnosis of the nature of CAS plaques in ICS patients were all significantly higher than those of CTA.Conclusion Compared with CTA,carotid artery plaque ultrasound has a higher diagnostic efficiency for the nature of CAS plaques in ICS patients and has certain clinical application value.
作者
刘会苗
杨青
张峰
姜喜锋
刘凯
LIU Hui-miao;YANG Qing;ZHANG Feng;JIANG Xi-feng;LIU Kai(Department of Ultrasound Diagnosis,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China;Department of Medical Imaging,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China;Department of Interventional,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China)
出处
《中国CT和MRI杂志》
2025年第2期53-56,共4页
Chinese Journal of CT and MRI
