Radiology:真真假假是否能看透--CTA在鉴别真假颈内动脉闭塞的能力有多大?

2018-01-06 shaosai MedSci原创

本研究旨在评价CTA在鉴别真假颈部颈内动脉(ICA)闭塞的准确性及稳定性,并将结果发表在Radiology上。

本研究旨在评价CTA在鉴别真假颈部颈内动脉(ICA)闭塞的准确性及稳定性,并将结果发表在Radiology上。

本研究共纳入了行血栓切除术并术前行CTA的患者(男性24例,女性13例;平均年龄为63岁,年龄范围为30-86岁)。7名阅片者包括5名神经放射学医师和两名介入神经放射学医师,他们独立地观察CTA图像来评价是否有真性ICA闭塞。观察结果与金标准数字剪影血管造影(DSA)进行比较。计算检出真性闭塞的敏感性、特异性、准确性及诊断比值比,以及组间及组内一致性。

结果为,在有症状侧颈部ICA中共有12/37例(32.4%)为假性闭塞。观察者间的一致性系数未达到足够地一致(≤0.6)。敏感性、特异性分别为68% (95% CI: 59%, 76%)、75% (95% CI: 71%, 80%),诊断比值比为8(95% CI: 3, 18),组间一致性一般(κ = 0.32; 95% CI: 0.16, 0.47)。

本研究表明,对于同侧ICA单期CTA有高密度的急性缺血性脑卒中的患者,专业的放射科医生也无法很好地鉴别真假颈部ICA闭塞。

原始出处:


本文系梅斯医学(MedSci)原创编译整理,转载需授权!

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=2022192, encodeId=4805202219297, content=<a href='/topic/show?id=cbec3334967' target=_blank style='color:#2F92EE;'>#动脉闭塞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33349, encryptionId=cbec3334967, topicName=动脉闭塞)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/017ED6AFEB45F49165298113DDC0656A/100, createdBy=84182500174, createdName=ms7019579240139182, createdTime=Mon Mar 19 04:59:00 CST 2018, time=2018-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1849578, encodeId=c53518495e873, content=<a href='/topic/show?id=61815385aa' target=_blank style='color:#2F92EE;'>#CTA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5385, encryptionId=61815385aa, topicName=CTA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec9955, createdName=windight, createdTime=Tue Aug 28 08:59:00 CST 2018, time=2018-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278946, encodeId=17732e8946d1, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Tue Jan 16 07:09:14 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1615738, encodeId=9e091615e3802, content=<a href='/topic/show?id=4b501005114a' target=_blank style='color:#2F92EE;'>#颈内动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100511, encryptionId=4b501005114a, topicName=颈内动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=71c019667486, createdName=644982816_68283327, createdTime=Mon Jan 08 14:59:00 CST 2018, time=2018-01-08, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=2022192, encodeId=4805202219297, content=<a href='/topic/show?id=cbec3334967' target=_blank style='color:#2F92EE;'>#动脉闭塞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33349, encryptionId=cbec3334967, topicName=动脉闭塞)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/017ED6AFEB45F49165298113DDC0656A/100, createdBy=84182500174, createdName=ms7019579240139182, createdTime=Mon Mar 19 04:59:00 CST 2018, time=2018-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1849578, encodeId=c53518495e873, content=<a href='/topic/show?id=61815385aa' target=_blank style='color:#2F92EE;'>#CTA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5385, encryptionId=61815385aa, topicName=CTA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec9955, createdName=windight, createdTime=Tue Aug 28 08:59:00 CST 2018, time=2018-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278946, encodeId=17732e8946d1, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Tue Jan 16 07:09:14 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1615738, encodeId=9e091615e3802, content=<a href='/topic/show?id=4b501005114a' target=_blank style='color:#2F92EE;'>#颈内动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100511, encryptionId=4b501005114a, topicName=颈内动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=71c019667486, createdName=644982816_68283327, createdTime=Mon Jan 08 14:59:00 CST 2018, time=2018-01-08, status=1, ipAttribution=)]
    2018-08-28 windight
  3. [GetPortalCommentsPageByObjectIdResponse(id=2022192, encodeId=4805202219297, content=<a href='/topic/show?id=cbec3334967' target=_blank style='color:#2F92EE;'>#动脉闭塞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33349, encryptionId=cbec3334967, topicName=动脉闭塞)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/017ED6AFEB45F49165298113DDC0656A/100, createdBy=84182500174, createdName=ms7019579240139182, createdTime=Mon Mar 19 04:59:00 CST 2018, time=2018-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1849578, encodeId=c53518495e873, content=<a href='/topic/show?id=61815385aa' target=_blank style='color:#2F92EE;'>#CTA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5385, encryptionId=61815385aa, topicName=CTA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec9955, createdName=windight, createdTime=Tue Aug 28 08:59:00 CST 2018, time=2018-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278946, encodeId=17732e8946d1, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Tue Jan 16 07:09:14 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1615738, encodeId=9e091615e3802, content=<a href='/topic/show?id=4b501005114a' target=_blank style='color:#2F92EE;'>#颈内动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100511, encryptionId=4b501005114a, topicName=颈内动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=71c019667486, createdName=644982816_68283327, createdTime=Mon Jan 08 14:59:00 CST 2018, time=2018-01-08, status=1, ipAttribution=)]
    2018-01-16 半夏微凉

    学习了谢谢分享

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=2022192, encodeId=4805202219297, content=<a href='/topic/show?id=cbec3334967' target=_blank style='color:#2F92EE;'>#动脉闭塞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33349, encryptionId=cbec3334967, topicName=动脉闭塞)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/017ED6AFEB45F49165298113DDC0656A/100, createdBy=84182500174, createdName=ms7019579240139182, createdTime=Mon Mar 19 04:59:00 CST 2018, time=2018-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1849578, encodeId=c53518495e873, content=<a href='/topic/show?id=61815385aa' target=_blank style='color:#2F92EE;'>#CTA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5385, encryptionId=61815385aa, topicName=CTA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec9955, createdName=windight, createdTime=Tue Aug 28 08:59:00 CST 2018, time=2018-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=278946, encodeId=17732e8946d1, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Tue Jan 16 07:09:14 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1615738, encodeId=9e091615e3802, content=<a href='/topic/show?id=4b501005114a' target=_blank style='color:#2F92EE;'>#颈内动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100511, encryptionId=4b501005114a, topicName=颈内动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=71c019667486, createdName=644982816_68283327, createdTime=Mon Jan 08 14:59:00 CST 2018, time=2018-01-08, status=1, ipAttribution=)]

相关资讯

Stroke:颈内动脉假闭塞的临床意义

血管内治疗已经成为大动脉闭塞性卒中治疗的金标准,任何原因的延误都将降低血管内治疗的疗效。颈部颈内动脉(ICA)假闭塞(pseudo-occlusion,PO)是一种血流假象,CTA或DSA显示颈部ICA完全闭塞,但实际上颅外ICA未闭塞。产生这个现象的原因很可能是因为动脉相时间太快,没有留意延迟影像;或远端不流动的血液(不显影)阻碍了造影剂进入动脉远端。我们可以在假闭塞的部位采用超选微导管造影确认

病例分析:时间上接近的多发梗死灶,除外心脏或主动脉弓栓塞,还应考虑这一点

1 病例简介患者男,74岁,因“头晕、右侧肢体力弱4日”于2011年4月26日入院。患者入院前半个月无明显诱因反复出现头晕(呈昏沉感),无视物旋转,站立或坐位头晕明显,平躺后减轻,与转颈和动作姿势无关,每次头晕发作持续1~2小时。头晕时伴视物模糊,视物时先出现闪光,后逐渐出现视物模糊。患者入院前4日反复出现右侧肢体无力伴头晕发作,右上肢抬举费力,抓物不准;右下肢可站立行走,但步态不稳。2011

Lancet:颈内动脉放置器械可治疗顽固性高血压

发表在Lancet上一项荷兰研究给顽固性高血压患者带来新希望。

Stroke:颈内动脉与椎动脉夹层表现明显不同

颈内动脉与椎动脉夹层的对比研究情况尚不明确,von Babo M等人比较了自发性颈内动脉夹层(sICAD)与自发性椎动脉夹层(sVAD)之间的潜在危险因素、临床症状、延迟诊断以及3个月的预后情况,发表在新一期的Stroke杂志上。该对比研究比较分析了3所大学附属医院sICAD (n=668) 和sVAD (n=302)病人。sICAD病人年龄更大(46.3±9.6 vs 42.0±10.2岁; P

Neuroradiology:CTA颅外颈内动脉火焰征在超急性缺血性脑卒中患者的诊断价值

颅外颈内动脉(ICA)火焰形假性闭塞是CTA和数字剪影血管造影(DSA)血流相关的表现,为颅内外ICA闭塞或夹层的假象。本研究旨在验证超急性缺血性脑卒中患者CTA火焰形颅外ICA征的诊断价值,并将结果发表在Neuroradiology上。