摘要
目的:研究颈部彩色多普勒超声检查(CDUS)与计算机断层血管摄影术(CTA)对中重度颈动脉狭窄的诊断价值。方法:选择我院行数字减影血管造影术(DSA)的112例疑似颈动脉狭窄,接受CDUS、CTA及两项联合检查患者,以DSA为金标准,对以上三种方法的诊断结果进行综合比较。结果:(1)CDUS、CTA及两项联合检查结果与DSA比较均具有一致性(Kappa=0.496、0.698、0.780,P均=0.001),提示以上三种检查均能达到DSA的诊断效果,其中两项联合检查与DSA一致性最高;(2)CDUS、CTA及两项联合检查的灵敏度分别为94.12%、96.08%、98.04%,特异度分别为60.00%、80.00%、80.00%,准确度分别为91.07%、94.64%、96.43%,阳性预测值分别为96.00%、98.00%、98.04%,阴性预测值分别为50.00%、66.67%、80.00%,三种检查以上诊断效能均无显著差异(P均>0.05);(3)CDUS、CTA及两项联合检查的受试者工作曲线(ROC)的曲线下面积(AUC)分别为0.771、0.880、0.890(P<0.05或<0.01),提示三种检查均具有中等应用价值;(4)CDUS、CTA及两项联合检查与DSA在中重度颈动脉狭窄患者的位置定位、颈动脉狭窄程度、颈动脉斑块质地的判断比较方面,无显著差异(P均>0.05)。结论:CDUS、CTA对于中重度颈动脉狭窄的诊断效果均与金标准DSA具有一致性,且联合检查的一致性更高,更具应用价值。
Objective:To study diagnostic value of carotid color Doppler ultrasonography(CDUS)and computed tomography for angiography(CTA)for moderate to severe carotid artery stenosis.Methods:A total of 112 patients suspecting of carotid stenosis who required digital subtraction angiography(DSA)in our hospital were selected.All patients received CDUS,CTA and combined examination of CDUS and CTA(dual examination,DE).With DSA as gold standard,outcomes of above three diagnostic methods were comprehensively compared.Results:(1)The diagnostic outcomes of CDUS,CTA and DE were consistent with that of DSA(Kappa=0.496,0.698,0.780,P=0.001 all),suggesting that above three examinations achieve the diagnostic effect of DSA,and DE possessed the highest consistency with DSA;(2)The sensitivity of CDUS,CTA and DE was 94.12%,96.08%and 98.04%respectively,specificity were 60.00%,80.00%and 80.00%respectively,accuracy was 91.07%,94.64%and 96.43%respectively,positive predictive value was 96.00%,98.00%and 98.04%respectively,and negative predictive value was 50.00%,66.67%and 80.00%respectively.There were no significant difference in above diagnostic efficacies among three examinations(P>0.05 all);(3)The area under the curve(AUC)of the receiver operating curve(ROC)of CDUS,CTA and DE was 0.771,0.880,0.890 respectively(P<0.05 or<0.01),suggesting that all three examinations possessed medium application value;(4)There were no significant difference in judgments of plaque location,carotid artery stenosis severity,carotid plaque texture among three examinations(P>0.05 all).Conclusion:Accuracies of CDUS and CTA are consistent with that of the gold standard DSA,and combined examination of CDUS and CTA is more consistent,which possesses higher application value.
作者
薄小波
施晓星
刘猛
BO Xiao-bo;SHI Xiao-xing;LIU Meng(Department of Imaging,Central Hospital of Zaozhuang Mining Group,Zaozhuang,Shandong,277800,China)
出处
《心血管康复医学杂志》
CAS
2020年第6期685-689,共5页
Chinese Journal of Cardiovascular Rehabilitation Medicine
关键词
颈动脉疾病
超声检查
多普勒
彩色
血管造影术
数字减影
Carotid artery diseases
Ultrasonography,Doppler,color
Angiography,digital subtraction
