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目的探讨CTA、TCD及DSA用于临床诊断颅内血管狭窄的准确性差异分析。方法收集2012年1月-2014年8月该院可疑颅内血管狭窄患者200例,对所有患者分别进行CTA、TCD和DSA三项检查,比较各项检查颅内动脉狭窄确诊情况,根据诊断金标准统计各项检查灵敏度和特异度,并根据上述统计数据分析和评价各项检查临床意义和价值。结果本研究200例待诊断患者最终确诊颅内狭窄患者174例,排除26例。可知DSA的灵敏度、特异度最高,CTA次之,而TCD最小,3组灵敏度差异有统计学意义(P<0.05),3组特异度差异无统计学意义(P<0.05)。误诊率由低到高依次为DSA、CTA和TCD,3组差异有统计学意义(P<0.05)。结论 TCD在颅内血管狭窄的诊断中灵敏度和特异度最低,诊断错误率最高,CTA次之,DSA作为诊断金标准其各项值最优。但TCD因其较小的特异度差异可用于疑似患者初检查和筛查。
Objective To investigate the accuracy of CTA, TCD and DSA in the diagnosis of intracranial vascular stenosis. Methods Totally 200 patients with suspected intracranial stenosis in our hospital from January 2012 to August 2014 were collected. Three patients underwent CTA, TCD and DSA examinations respectively. The diagnosis of intracranial arterial stenosis was compared between the two groups. Standard statistical sensitivity and specificity of each test, and based on the above statistical data analysis and evaluation of clinical significance and value of the inspection. Results The final diagnosis of 200 cases of patients to be diagnosed in this study 174 cases of intracranial stenosis, excluding 26 cases. The sensitivity and specificity of DSA were the highest, followed by CTA, while the TCD was the smallest. There was significant difference between the three groups in sensitivity (P <0.05). There was no significant difference in the three groups (P <0.05). The misdiagnosis rates were DSA, CTA and TCD from low to high, and the differences among the three groups were statistically significant (P <0.05). Conclusion TCD has the lowest sensitivity and specificity in the diagnosis of intracranial vascular stenosis, the highest diagnostic error rate and the second is CTA. DSA is the best gold standard for diagnosis. TCD, however, can be used for initial screening and screening of suspected patients because of its small specificity.