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1、头颈联合128层螺旋CT血管成像在颅内外动脉狭窄中诊断价值的研宄刘国庆何泽清杨秀娟(重庆三峡屮心医院重庆万州404000)【摘要】目的：探讨尖颈联合128-SSCTA对颅內外动脉狭窄的诊断价值。方法：34例患者行128-SSCTA检查后，2周内行DSA。分别参照华法林-阿司匹林症状性领内动脉疾病研究(Warfarin-AspirinSymptomaticIntracranialDiseasStudy,WASIDS)使用的测量方法和北美症状性颈动脉内膜切除试验标准(NorthAmericanSymptomaticCarotidEndarterectomyTr
2、ial,NASCET)对卢页内外血管狭窄率进行分级。以DSA为标准，评价128-SSCTA诊断血管狭窄的准确率、敏感度、特异度、阳性预测值及阴性预测值。结果：128-SSCTA诊断160支血管狹窄或闭塞，轻度狭窄93支，屮度狭窄48支，重度狭窄12支，闭塞7支，418支血管正常。DSA诊断155支血管狭窄或闭塞，轻度狭窄104支，屮度狭窄33支，重度狭窄11支，闭塞7支，423支血管正常。以DSA为“金标准”，128-SSCTA检出颅内外血管病变总的准确率、敏感度、特异度、阳性预测值及阴性预测值分别为971%(561/578)、961%(149/155)、
3、974%(412/423)、931%(149/160)及986%(412/418)。128-SSCTA和DSA对血管狭窄检出率差异无统计学意义(x2=3465,P=0483)。结论：128-SSCTA对颅内、外动脉狭窄的诊断具有较高敏感度、特异度和准确率，可作为动脉狭窄筛查与诊断的常规检查方法。【关键词】128层螺旋CT;血管成像；数字减影血管造影；颅内外动脉狹窄Studyofheadandneckwith128slicespiralCTangiographyinintracranialandextracranialarterystenosisdiagno
4、sisvalueLiuGuoqingHeZeqingYangXiujuan(CentralHospitalofChongqingThreeGorges,Chongqing,Wanzhou,404000)【Abstract】Objective:Toinvestigatethevalueof128-SSCTAinheadandneckcombinedintracranialandextracranialarterystenosisdiagnosis.Methods:34patientswhounderwent128-SSCTAexaminationafter2
5、weeks,DSA.Warfarinandaspirinrespectivelyaccordingtosymptomaticintracranialarterialdiseaseresearch(Warfarin-AspirinSymptomaticIntracranialDiseasStudy,WASIDS)measurementmethodusingandtheNorthAmericanSymptomaticCarotidEndarterectomyTrialstandard(NorthAmericanSymptomaticCarotidEndarte
6、rectomyTrial,NASCET)classificationofintracranialandextracranialvascularstenosisrate.WithDSAasthestandard,evaluationof128-SSCTAdiagnosisofvascularstenosisofaccuracy,sensitivity,specificity,positivepredictivevalueandnegativepredictivevalue.Results:128-SSCTAdiagnosis160vesselocclusio
7、norstenosis,93mildstenosis,48moderatestenosis,severestenosis12,block7,418vesselsinnormal.DSAdiagnosisof155vesselocclusionorstenosis,104mildstenosis,33moderatestenosis,severestenosis11,block7,423vesselsinnormal.TakingDSAasthe"goldstandard’1,theaccuracyof128-SSCTA,extracranialandint
8、racranialvascularlesionsintotalse
