Abstract: Objective To evaluate the clinical application value of 64-slice spiral computed tomography(CT)angiography to intracranial artery stenosis and cervical artery stenosis.Methods The datas of 64-slice spiral computed tomography angiography(64-SSCTA) and digitalsubtraction angiography(DSA) in seventy-four patients with transient ischemic attack or ischemicwere retrospective analyzed and the level of intra or extra-cranial artery stenosis were evaluated.According to “gold standard” of DSA, the sensibility, specificity and accuracy rating of 64-SSCTAhad been calculated respectively; and the identical degree of angiostegnosis detected by DSA and64-SSCTA was assessed.Results In the 74 patients, 814 intra or extra-cranial arteries had been evaluated. Among the 117arteries which had stenosis discovered by 64-SSCTA, there were 103 stenosis had been confirmedby DSA. There were 9 artery stenosis confirmed by DSA did not discovered by 64-SSCTA.According to “gold standard” of DSA, the sensibility, specificity and accuracy rating of 64-SSCTAto the affection were 92.0%, 98.0% and 97.2% respectively. The difference in detection ratebetween 64-SSCTA and DSA has no significance(χ2=0.076, P =0.439).Conclusion Sixty-four-slice spiral CT angiography long coverage in intracranial and cervical arteriesis a quick and harmless examination. To the patients with ischemic cerebrovascular disease, 64-SSCTAhave high sensibility, specificity and accuracy rating in detecting patient's vascular lesions.

Key words: Tomography; spiral computed; Cerebral angiography; Angiography; digitalsubtraction; Carotid stenosis

摘要： 目的 探讨头颈联合64层螺旋CT血管成像（64-slice spiral computed tomography angiography，64-SSCTA）诊断颅内外动脉狭窄的临床价值。方法 回顾性分析74例临床确诊为短暂性脑缺血发作（transient ischemic attack，TIA）和缺血性卒中患者行64-SSCTA及数字减影血管造影（digital subtraction angiography，DSA）影像资料。以DSA作为“金标准”，计算64-SSCTA显示血管狭窄的敏感性、特异性、准确率；并对比64-SSCTA和DSA显示血管狭窄的符合程度。结果 74例患者共有814支动脉血管接受评价，64-SSCTA显像中诊断为狭窄或闭塞的有117支，其中103支被DSA证实；有697支诊断为正常的血管，其中688支与DSA结果一致。以DSA作为“金标准”计算出64-SSCTA对患者头颈血管病变检出的敏感性、特异性及准确率分别为92.0%、98.0%和97.2%。64-SSCTA与DSA的吻合系数Kappa =0.81，P＜0.01。对比分析发现，64-SSCTA和DSA对血管狭窄检出率差异无统计学意义（χ2=0.076，P =0.439）。结论 64-SSCTA对颅内、外动脉血管狭窄诊断具有较高的敏感性、特异性和准确率，可能为颅内、外动脉血管狭窄提供一种常用的、无创的检测手段，并为颅内、外动脉狭窄的临床治疗提供较为详尽、客观、准确的影像依据。

关键词: 体层摄影术; 螺旋计算机; 脑血管造影术; 血管造影术; 数字减影; 颈动脉狭窄