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目的:对比分析颈部动脉超声(US)与CT血管造影(CTA)对颈动脉狭窄检测的临床价值。方法:选取2015年12月-2016年12月笔者所在医院收治的90例颈动脉狭窄病变患者,均进行US和CTA检测,并以数字减影血管造影(DSA)检测为金标准,对比分析两者对颈动脉狭窄检测的准确度、灵敏度、特异度等指标,以及与DSA检查结果的一致性。结果:超声检测准确度、灵敏度、特异度、漏诊率、误诊率分别为75.8%、80.5%、68.9%、19.5%、31.1%,阳性预测值、阴性预测值分别为51.2%、76.9%,一致性较差(K=0.31);CTA检测的准确度、灵敏度、特异度、漏诊率、误诊率为82.5%、78.2%、80.1%、21.8%、19.9%,阳性预测值、阴性预测值分别为63.7%、76.2%,一致性不理想(K=0.36)。联合检查灵敏度明显提高,与DSA一致性中等(K=0.45)。结论:超声和CTA检测颈动脉狭窄病变和DSA一致性较差,而两者联合检测的灵敏度明显提高、漏诊率降低,且与DSA一致性较单一方法要高,对颈动脉狭窄的检测效能提升,但仍不能替代DSA。
Objective: To compare the clinical value of carotid artery stenosis between carotid artery ultrasound (US) and CT angiography (CTA). Methods: Ninety patients with carotid stenosis who were admitted to our hospital from December 2015 to December 2016 were enrolled in the US and CTA examinations, and the digital subtraction angiography (DSA) was taken as the gold standard. The comparative analysis of two The accuracy of carotid artery stenosis, sensitivity, specificity and other indicators, as well as the consistency with the DSA test results. Results: The accuracy, sensitivity, specificity, missed diagnosis and misdiagnosis rates of ultrasound were 75.8%, 80.5%, 68.9%, 19.5% and 31.1% respectively. The positive predictive value and negative predictive value were 51.2% and 76.9% The accuracy, sensitivity, specificity, missed diagnosis rate and misdiagnosis rate of CTA were 82.5%, 78.2%, 80.1%, 21.8% and 19.9% respectively. The positive predictive value and negative predictive value were 63.7%, 76.2%, the consistency is not ideal (K = 0.36). Joint examination significantly increased sensitivity, consistent with the DSA (K = 0.45). Conclusion: Ultrasound and CTA detection of carotid artery stenosis lesion and DSA consistency is poor, and the combined detection of the two significantly increased the sensitivity, missed diagnosis rate and DSA consistent higher than the single method, the detection of carotid artery stenosis increased efficiency , But still can not replace the DSA.