摘要
目的探讨颈部血管超声血流显像(CDFI)和CT血管造影(CTA)在颈动脉重度狭窄患者术前诊断、术后随访中的应用价值。方法回顾性研究。抽取2021年5月至2022年9月于河南省第三人民医院及河南省人民医院接受手术治疗的114例颈动脉狭窄患者作为研究对象,所有患者均在术前、术后半年实施CDFI、CTA检查,均随访半年。以数字减影血管造影(DSA)检查结果为"金标准",统计CDFI、CTA诊断颈动脉重度狭窄的诊断结果和诊断效能,比较术前和术后半年患者的CDFI检查结果[狭窄段收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)]和CTA检查结果(狭窄远端直径、最小残余直径)。结果114例颈动脉狭窄患者中,经DSA检查确诊重度狭窄79例,非重度狭窄35例;CDFI诊断出重度狭窄75例,非重度狭窄27例;CTA诊断出重度狭窄77例,非重度狭窄30例。CDFI诊断颈动脉重度狭窄的灵敏度、特异度、准确度[94.94%(75/79)、77.14%(27/35)、89.47%(102/114)]与CTA诊断[97.47%(77/79)、85.71%(30/35)、93.86%(107/114)]比较差异未见统计学意义(P>0.05)。术后半年,患者的PSV、EDV水平均低于术前(P均<0.05),患者的狭窄远端直径、最小残余直径均大于术前(P均<0.05)。结论CDFI、CTA对颈动脉重度狭窄的诊断效能相当,均有较高的灵敏度和准确度,均能指导手术及术后随访检查,临床可根据患者实际情况选择合适的诊断方法。
Objective To analyze the value of cervical vascular ultrasound color Doppler flow imaging(CDFI)and computed tomography angiography(CTA)in preoperative diagnosis and postoperative follow-up of patients with severe carotid artery stenosis.Methods This study was a retrospective trail.A total of 114 patients with carotid artery stenosis who underwent surgical treatment in Henan No.3 Provincial People’s Hospital from May 2021 to September 2022 were selected as the study subjects.All patients underwent CDFI and CTA examinations before and 3 months after surgery,and they were followed up for 6 months.Results of digital subtraction angiography(DSA)was used as the gold standard,the results and efficacy of CDFI and CTA in diagnosing severe carotid artery stenosis were compared.The results of CDFI examination,including peak systolic velocity(PSV)and end diastolic velocity(EDV),and CTA results(narrowing distal diameter,minimum residual diameter)of patients were compared before and 6 months after surgery.Results Among the 114 patients with carotid artery stenosis,DSA identified 79 cases of severe stenosis and 35 cases of non-severe stenosis.CDFI identified 75 cases of severe stenosis and 27 cases of non-severe stenosis.CTA identified 77 cases of severe stenosis and 30 cases of non-severe stenosis.There was no significant difference in sensitivity,specificity and accuracy between CDFI(94.94%,75/79;77.14%,27/35;89.47%,102/114)and CTA(97.47%,77/79;85.71%,30/35;93.86%,107/114)in the diagnosis of severe carotid artery stenosis(P>0.05).Six months after operation,the levels of PSV and EDV were lower than preoperative levels(all P<0.05),while the narrowing distal diameter and minimum residual diameter were higher(all P<0.05).Conclusions CDFI and CTA have similar diagnostic efficacy in diagnosing severe carotid artery stenosis,with high sensitivity and accuracy.They can guide surgery and postoperative follow-up examinations.In clinical practice,appropriate diagnostic methods can be selected based on the actual situation of patients.
作者
姚延丹
秦砚戈
张胜龙
李沆
佘亚鹏
Yao Yandan;Qin Yange;Zhang Shenglong;Li Hang;She Yapeng(Department of Ultrasound,Henan No.3 Provincial People’s Hospital,Henan Provincial Occupational Disease Hospital,Zhengzhou 451162,China;Department of Emergency,Henan Provincial People’s Hospital,Zhengzhou 450000,China;Department of Health Examination,Zhengzhou Cardiovascular Hospital,the Seventh People’s Hospital of Zhengzhou,Zhengzhou 450000,China)
出处
《中国实用医刊》
2024年第2期98-101,共4页
Chinese Journal of Practical Medicine
关键词
颈动脉狭窄
颈部血管超声血流显像
CT血管造影
Carotid stenosis
Cervical vascular ultrasound color Doppler flow imaging
Computed tomography angiography
