摘要
目的探讨MSCT血管成像(CTA)在孤立性肠系膜上动脉夹层(ISMAD)诊断中的应用价值。方法回顾性分析2012—2019年28例经数字减影血管造影(DSA)确诊为ISMAD患者的影像资料,由2名经验丰富的放射科医生对CT图像进行分析,以DSA结果为金标准,评价CTA诊断ISMAD的敏感度、特异度和准确率,并评估CTA与DSA检查结果的一致性。结果28例ISMAD患者中,DSA确诊28例,CTA确诊26例,漏诊1例,误诊1例。ISMAD病变形态构成:Ⅰ型夹层8例,CTA均诊断正确,Ⅱ型夹层7例,CTA确诊7例,Ⅲ型夹层4例,CTA确诊3例,漏诊1例,Ⅳ型夹层9例,其中1例DSA显示为线样征,而CTA误诊为附壁血栓。CTA诊断ISMAD的敏感度、特异度和准确率分别为96.4%(27/28)、100%(26/26)和92.3%(26/28)。CTA与DSA诊断结果具有较好的一致性(Kappa值为0.948,P<0.01)。结论CTA在ISMAD诊断中具有重要应用价值。
Objective To explore the value of multi-slice spiral CT angiography(CTA)in the diagnosis of isolated superior mesenteric artery dissection(ISMAD).Methods The imaging data of 28 patients diagnosed with ISMAD by digital subtraction angiography(DSA)from 2012 to 2019 were retrospectively analysed.Two experienced radiologists analysed the CT images.The DSA results was taken as the gold standard to evaluate the sensitivity,specificity and accuracy of CTA in diagnosing ISMAD.The consistency of DSA and CTA results were evaluated by Kappa test.Results Among the 28 cases of ISMAD,28 cases were diagnosed by DSA,26 cases were confirmed by CTA,1 case was missed,and 1 case was misdiagnosed.The morphology of ISMAD lesions:8 cases of typeⅠdissection,all diagnosed by CTA.Seven cases of typeⅡdissection,all diagnosed by CTA.Four cases of typeⅢdissection,3 cases were diagnosed by CTA,1 case were missed.Nine cases of typeⅣdissection,1 case of DSA showed linear signs,while CTA was misdiagnosed as mural thrombus.The sensitivity,specificity,accuracy of CTA in diagnosing ISMAD dissection were 96.4%(27/28),100%(26/26),92.3%(26/28)respectively.Conclusion Multi-slice spiral CTA has important application value in the diagnosis of ISMAD.
作者
陈望
马竹青
CHEN Wang;MA Zhu-qing(Department of Radiology,the First Affiliated Hospital of Henan Science and Technology University,Luoyang 471003,China)
出处
《河南医学研究》
CAS
2020年第20期3673-3676,共4页
Henan Medical Research
