摘要
目的探讨CT脑灌注成像(CTP)和CT血管成像(CTA)对颈内动脉和大脑中动脉狭窄或闭塞的诊断价值。方法选取2019年1月至2020年12月咸阳市第一人民医院确诊为颈内动脉和大脑中动脉狭窄或闭塞的患者107例(病例组),另选取同期参加体检的高血压患者35例(对照组)。两组受检者均做CTP与CTA检查,比较两组受检者的动脉狭窄检出率、脑血流动力学参数;病例组患者再进行脑血管造影(DSA),以DSA为金标准,分析CTA联合CTP诊断与金标准的一致性,计算灵敏度、特异度。结果病例组患者轻度狭窄、中度狭窄、重度狭窄、完全闭塞的检出率分别为25.23%、47.66%、16.82%、10.28%,明显高于对照组的85.71%、14.29%、0、0,差异均有显著统计学意义(P<0.01);病例组患者的脑血流量为(64.38±7.55)mL/min,明显低于对照组的(70.23±6.18)mL/min,差异有显著统计学意义(P<0.01);病例组患者的脑血容量、平均通过时间、达峰时间分别为(4.12±0.73)mL、(13.56±1.15)s、(4.22±0.29)s,明显长于于对照组的(2.09±0.56)mL、(10.35±1.22)s、(3.67±0.34)s,差异均有显著统计学意义(P<0.01);不同狭窄程度患者的脑血流动力学参数有显著差异,在脑血流量方面,完全闭塞<重度狭窄<中度狭窄<轻度狭窄,差异有显著统计学意义(P<0.01);在脑血容量、平均通过时间和达峰时间方面,完全闭塞>重度狭窄>中度狭窄>轻度狭窄,差异均有显著统计学意义(P<0.01);以DSA为金标准,CTA联合CTP鉴别重度狭窄或完全闭塞的灵敏度为80.65%,特异度为94.74%,准确率为90.65%,与DSA一致性较高(Kappa=0.768)。结论CTA联合CTP不仅能较好鉴别颈内动脉和大脑中动脉狭窄程度,而且还能评估脑血流动力学,临床应用价值高。
Objective To investigate the diagnostic value of CT perfusion(CTP)imaging and CT angiography(CTA)in internal carotid artery and middle cerebral artery stenosis or occlusion.Methods A total of 107 patients who diagnosed with internal carotid artery and middle cerebral artery stenosis or occlusion in the First People’s Hospital of Xianyang from January 2019 and December 2020 were selected as the case group.In addition,35 hypertensive patients who attended the physical examination at the same period were selected(control group).Both groups were examined for CTP and CTA.The detection rate of arterial stenosis and cerebral hemodynamic parameters were compared between the two groups.Patients in the case group were examined with digital subtraction angiography(DSA).Taking DSA as the gold standard,the consistency of CTAcombined with CTP and gold standard was analyzed,and the sensitivity and specificity were calculated.Results The detection rates of mild stenosis,moderate stenosis,severe stenosis,and complete occlusion in the case group were 25.23%,47.66%,16.82%,and 10.28%,which were significantly higher than 85.71%,14.29%,0 and 0 in the control group(P<0.05).The cerebral blood flow of the case group was(64.38±7.55)m L/min,which was significantly lower than(70.23±6.18)mL/min of the control group(P<0.05).The cerebral blood volume,mean transit time,and peak time of the case group were(4.12±0.73)m L,(13.56±1.15)s,and(4.22±0.29)s,which were significantly longer than(2.09±0.56)m L,(10.35±1.22)s,(3.67±0.34)s of the control group(P<0.05).There were significant differences in cerebral hemodynamic parameters between patients with different degrees of stenoses.In terms of cerebral blood flow,the order was complete occlusion<severe stenosis<moderate stenosis<mild stenosis,and the differences were statistically significant(P<0.01).In terms of cerebral blood volume,mean transit time,and peak time,the order was complete occlusion>severe stenosis>moderate stenosis>mild stenosis,and the differences were statistically significan
作者
杨毅
侯浩宇
YANG Yi;HOU Hao-yu(MR Room of the Imaging Center,the First People's Hospital of Xianyang,Xianyang 712000,Shaanxi,CHINA;CT Room of the Imaging Center,the First People's Hospital of Xianyang,Xianyang 712000,Shaanxi,CHINA)
出处
《海南医学》
CAS
2022年第4期486-490,共5页
Hainan Medical Journal
基金
陕西省卫生厅科研基金项目(编号:2016D156)。
关键词
CT灌注成像
CT血管成像
颈内动脉
大脑中动脉
动脉狭窄
CT perfusion imaging
CT angiography
Internal carotid artery
Middle cerebral artery
Arterial stenosis
