摘要
目的探讨多层螺旋CT与数字减影血管造影术(DSA)在主动脉夹层诊断中的临床价值。方法选择疑似主动脉夹层患者46例作为研究对象,分别实施DSA和多层螺旋CT检查,以术后诊断结果为金标准。对两种诊断方法的诊断价值进行评估。结果多层螺旋CT和DSA对真假腔和内膜瓣的检出率差异无统计学意义(P>0.05);DSA对主动脉夹层破口数和受累分支的检出率显著低于多层螺旋CT(P<0.05)。多层螺旋CT与DSA对主动脉夹层第一破口大小,第一破口与左锁骨下动脉距离,左锁骨下动脉开口平面胸主动脉最大径和真腔远端直径的测量值差异均无统计学意义(P>0.05)。DSA对主动脉夹层诊断的敏感性、准确性和特异性分别为0.976,0.667和0.8;多层螺旋CT对主动脉夹层的诊断的敏感性、准确性和特异性分别为0.951,0.662和0.8。Kappa检验表明两种诊断方法诊断结果与金标准均有较高的一致性。结论两种诊断方法对主动脉夹层的诊断与金标准均具有较高的一致性,但多层螺旋CT应用范围更广,安全性更高,在临床应用价值更高。
Objective To investigate the clinical value of multi-slice spiral CT and DSA in diagnosis of aortic dissection.Methods Forty-six patients with suspected aortic dissection who were diagnosed and treated in our hospital from May 2012 to March 2016 were enrolled in the study .These patients were examined by DSA and multi-slice spiral CT , respectively .Then the diagnostic value of two diagnostic methods was evaluated and compared by taking the postoperative diagnosis results as gold standard .Results There were no significant differences in the detection rates of true and false lumen and intimal flap between multislice spiral CT and DSA （ P 〉0.05）.The detection rates of aortic dissection and the number of branches by DSA were significantly lower than those by multislice spiral CT （ P 〈0.05）.There were no significant differnces in the measured values of the first crevasse size , distance from the first crevasse to the left subclavian artery （ LSA） ,the LSA plane thoracic aortic maximum diameter and true lumen distal diameter of aortic dissection between multi -slice spiral CT and DSA （ P 〉0.05）.The sensitivity,accuracy and specificity of DSA in diagnosis of aortic dissection were 0.976,0.667, 0.8, respectively,and which were 0.951, 0.662, 0.8, respectively in multislice spiral CT .The Kappa test showed that both diagnostic methods had good consistency with gold standard .Conclusion The two diagnostic methods in diagnosis of aortic dissection have higher consistency with gold standard , but multi-slice spiral CT has wider application range ,with higher safety , thus,which has higher clinical application value .
出处
《河北医药》
CAS
2017年第2期194-196,200,共4页
Hebei Medical Journal
