多层螺旋CT血管造影在诊断颈动脉狭窄疾病中的临床应用.docxVIP

多层螺旋CT血管造影在诊断颈动脉狭窄疾病中的临床应用 杨天富何华(南雄市人民医院广东南雄512400) 【中图分类号】R445 [文献标识码】A【文章编号】1672-5085 (2012) 20-0028-02 【摘要】目的探讨多层螺旋CT血管造影(MSCTA)诊断颈动脉狭窄的准确性及应 用价值。方法对21例经颈动脉多普勒超声筛选的颈动脉狭窄及闭塞患者，经多 层螺旋CT平扫及增强扫描后得到颈动脉和椎动脉各42支，分别用最大密度投影 (MIP)、多平面重组(MPR)、曲面重组(CPR)及容积重建(SVR)方法进行重建，显示 颈部动脉衣各平面情况，获取完整颈部动脉图像，采用北美颈动脉切除术标准及 CT值对动脉狭窄程度进行判定。结果木组21例患者共检出30支颈动脉狭窄病 变。CTA检出I度狭窄12支、II度狭窄10支、III及IV度狭窄8支，经计算CTA 检出颈动脉I度狭窄的敏感度(Se)69?2%、特异度(Sp)95?3%、误诊率(a)4.7%、漏 诊率⑻30.1%； II度狭窄的敏感度(Se) 82.1%、特异度(Sp) 97.6%、误诊率(a)2.4%、 漏诊率(B) 17.9%； III及IV度狭窄的敏感度(Se)93.3%、特异度(Sp) 98.1%.误诊率 (a)1.9%＞漏诊率⑻6.7% o结论多层螺旋CT血管造影(MSCTA)能比较准确地判 断颈动脉狭窄程度及范围，有很大的临床应用价值，在颈动脉狭窄诊断中占重要 地位。 【关键词】颈动脉狭窄 多层螺旋CT血管造影 [Abstract] objective:to study the multisliceCTangiography (MSCTA) diagnosis of carotid stenosis and accuracy of the application value.Methods:twenty-one cases of the carotid artery doppler ultrasound screening of carotid stenosis and block patientszthe MDCTflat and enhance scan and get the carotid artery and vertebral artery each 42 bran ch,respectively for most den sity projection (l\ZIIP),many plane reorganization (MPR)’curved surface restructuring (CPR) and volume (SVR) method rec on structio n rec on structi on ,show the n eck in the plane artery,get the full cervical artery image,the north American carotid artery resection standards andCTvalue on the artery stenosis degree judgement.Results:the 21 patients were detected with 30 carotid artery stenosis lesions.CTA detection I degrees with 12, II degrees narrow narrow ten bottles,III and IV degree 8 a narrow,and through calculation’CIA detection carotid artery I degrees narrow sensitivity (Se) 69.2%,specific degrees (Sp) 95.3%,the misdiagnosis rate (a) 4.7%,the missed diagnosis (B) 30.1%; II degrees narrow sensitivity (Se) 82.1%,specific degrees (Sp) 97.6%,the misdiagnosis rate (a) 2.4%,the missed diagnosis (B) 17.9%; III and IV degrees narrow sensitivity (Se) 93.3%,specific degrees (Sp) 98.1%,the misdiagnosis rate (a) 1.9%,the missed diagnosis (B) 6.7%.Conclusion:multisliceCTa