摘要
目的探讨颈部彩色多普勒超声(color doppler ultrasound,CDUS)与CT血管造影(CT angiography,CTA)对颈动脉狭窄病变的诊断价值。方法回顾性选取2021年1月—2023年6月于松原吉林油田医院就诊的70例缺血性脑血管患者,整理并分析其临床资料。所有患者均接受数字减影造影(digital subtraction angiography,DSA)、CDUS、CTA检查。比较CDUS、CTA检出结果、诊断效能、阴性组与阳性组的血流动力学参数、2种检查方式对颈动脉斑块的检出结果,并对其中的典型病例进行分析。结果70例缺血性脑血管患者经DSA检查后,确诊为阳性者21例,阴性49例。经CDUS检查阳性30例,阴性40例,其中仅有17例确诊为颈动脉狭窄病变;经CTA检查,阳性27例,阴性43例,其中仅有20例确诊为颈动脉狭窄病变。CTA检查的准确度更高于CDUS;经比较发现,CTA的颈动脉斑块检出率高于CDUS;差异有统计学意义(P<0.05);2种诊断方式的敏感度与特异度比较,差异无统计学意义(P>0.05);根据DSA检查结果将患者分为阴性组与阳性组,分别49例、21例,阳性组颈内动脉收缩期峰值流速(peak systolic flow velocity of internal carotid artery,PSV)、舒张期末流速(end diastolic flow velocity,EDV)均高于阴性组,大脑中动脉搏动指数(arterial pulsation index,PI)、平均血流速度(average blood flow velocity,Vm)均低于阴性组,差异有统计学意义(P<0.05)。结论相较于CDUS,CTA检测准确性较高,具备一定应用优势,但需注射对比剂,应用范围受到一定局限。CDUS准确性相对较低,但同时具备重复性良好、无创等优势,还可对患者脑部血流状态学进行检测。CTA的颈动脉斑块检出率更高,但斑块分型准确性不高。2种检查方式均具备独特优势,临床应用时可从实际需求出发选择合适的检查方式。
Objective To explore the diagnostic value of neck color doppler ultrasound(CDUS)and CT angiography(CTA)in carotid stenosis.Methods A total of 70 patients with ischemic cerebrovascular disease who were treated in Songyuan Jilin Oilfield General Hospital from January 2021 to June 2023 were retrospectively selected,and their clinical data were sorted out and analyzed.All patients were examined by digital subtraction angiography(DSA),CDUS and CTA.The detection results of CDUS and CTA,diagnostic efficiency and hemodynamic parameters of the negative group and the positive group were compared,detection results of carotid plaque by two examination methods.And the typical cases were analyzed.Results A total of 70 patients with ischemic cerebrovascular disease were diagnosed as positive in 21 cases and negative in 49 cases after DSA examination.30 cases were positive and 40 cases were negative by CDUS,of which only 17 cases were diagnosed as carotid stenosis.After CTA examination,27 cases were positive and 43 cases were negative,of which only 20 cases were diagnosed as carotid stenosis.The accuracy of CTA was higher than that of CDUS.The detection rate of carotid plaque in CTA was higher than that in CDUS,the difference was statistically significant(P<0.05).There was no significant difference in sensitivity and specificity between the two diagnostic methods(P>0.05).According to the results of DSA examination,the patients were divided into the negative group and the positive group,49 cases and 21 cases respectively.Compared with the negative group,the peak systolic flow velocity of internal carotid artery(PSV)and end diastolic flow velocity(EDV)of the positive group were higher,and the arterial pulsation index(PI)and average blood flow velocity(Vm)were lower,the differences were statistically significant(P<0.05).Conclusion Compared with CDUS,CTA has higher detection accuracy and certain application advantages,but it needs injection of contrast agent,and its application scope is limited.The accuracy of CDUS is relatively low
作者
马金龙
刘强
MA Jinlong;LIU Qiang(Department of Functional,Songyuan Jilin Oilfield General Hospital,Songyuan Jilin 138001,China;Department of Neurology,Songyuan Jilin Oilfield General Hospital,Songyuan Jilin 138001,China)
出处
《中国卫生标准管理》
2024年第8期141-145,共5页
China Health Standard Management
