摘要
目的探究腹部CT血管造影对主动脉夹层(AD)的诊断价值。方法收集2016年11月至2019年11月我院收治的80例疑似AD患者为研究对象,患者均行CT平扫及腹部CT血管造影检查(两项检查时间相隔时间<7d),比较CT平扫、腹部CT血管造影检查诊断AD的效能、对AD分型的检出率以及两种检查方法的扫描图像质量及主动脉根部伪影发生率。结果以经手术病理或主动脉造影结果为“金标准”,腹部CT血管造影检查诊断AD的价值(Kappa值=0.689)明显高于CT平扫(Kappa值=0.324)。腹部CT血管造影检查诊断AD的灵敏度和准确度明显高于CT平扫(P<0.05),但两者诊断AD的特异度比较差异不显著(P>0.05);术后病理结果提示66例AD患者AD分型Ⅰ型29例、Ⅱ型17例、ⅢA型11例、ⅢB型9例,腹部CT血管造影检查对AD分型为Ⅰ型的检出率明显高于CT平扫(P<0.05);腹部CT血管造影扫描图像质量明显高于CT平扫,而主动脉根部伪影发生率明显低于CT平扫(P<0.05)。结论腹部CT血管造影对AD早期诊断价值、Ⅰ型检出率明显高于CT平扫,可为AD早期诊治和预后评估提供参考。
Objective To explore the diagnostic value of abdominal CT angiography for aortic dissection(AD).Methods Eighty patients suspected of AD admitted to the hospital from November 2016 to November 2019 were enrolled.All patients underwent CT scan and abdominal CT angiography(7d interval between the two examinations).The diagnostic efficiency for AD,the detection rate for AD typing,scan image quality,and incidence of aortic root artifact by the two examination methods were compared.Results Taking results of surgical pathology or aortic angiography as the golden standard,the diagnostic value of abdominal CT angiography was significantly higher than that of CT scan for AD(Kappa value:0.689 vs.0.324),and its diagnostic sensitivity and accuracy were significantly higher than those of CT scan(P<0.05).There was no significant difference in diagnostic specificity of AD between the two examinations(P>0.05).Postoperative pathological results suggested that among AD 66 patients,there were 29 cases with AD typing of typeⅠ,17 cases of typeⅡ,11 cases of typeⅢA and 9 cases of typeⅢB,respectively.The detection rate of abdominal CT angiography for type I was significantly higher than that of CT scan(P<0.05).The scan image quality of abdominal CT angiography was significantly higher than that of CT scan,while the incidence of aortic root artifacts was significantly lower than that of CT plain scan(P<0.05).Conclusion The early diagnostic value for AD and type I detection rate by abdominal CT angiography are significantly higher than those by CT scan,and it may provide a reference for early diagnosis and treatment of AD and prognosis evaluation.
作者
杨娟
王晓慧
师芳芳
闫婧
YANG Juan;WANG Xiao-hui;SHI Fang-fang;YAN Jing(Department of Radiology,Yan'an University Affiliated Hospital,Yan'an 716000,Shaanxi Province,China;Department of Radiology,Dongguan Branch of Yan'an University Affiliated Hospital,Yan'an 716000,Shaanxi Province,China;Medical College of Yan'an University,Yan'an 716000,Shaanxi Province,China)
出处
《中国CT和MRI杂志》
2021年第12期154-156,共3页
Chinese Journal of CT and MRI
基金
陕西省教育厅2017年专项科学研究计划项目(17JK0863)。
