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目的 探讨64层螺旋CT薄块(thin-slab)曲面(CPR)最大密度投影(MIP)在椎动脉型颈椎病(vertebralarterial insufficiency of cervical spondylosis,CSA)诊断中的价值.资料与方法 对58例临床拟诊CSA患者行64层螺旋CT动脉成像(CTA).扫描后所得容积数据采用thin-slab CPR MIP方法进行图像后处理.以DSA为金标准,评价thin-slab CPR MIP对椎动脉(VA)狭窄显示的敏感性、准确性、阳性预测值、阴性预测值并就两者对狭窄判断的一致性予以分析.结果 58例中,CT和DSA均完成了116支VA检查,thin-slab CPR MIP和DSA中,共有98支具有一致性;当狭窄率≥70%时,thin-slab CPR MIP方法的敏感性、特异性、阳性预测值、阴性预测值分别为100%(19/19)、96.9%(94/97)、86.4%(19/22)、100%(94/94);当狭窄率≥50%时,thin-slab CPR MIP方法的敏感性、特异性、阳性预测值、阴性预测值分别为97.3%(36/37)、94.9%(75/79)、90%(36/40)、98.7%(75/76).结论 thin-slab CPR MIP在诊断VA狭窄程度上与DSA有很高的一致性,可准确显示VA粥样硬化情况和软、硬斑块,并能显示椎间孔周围骨质增生对VA的压迫情况,是VA CTA较好的一种后处理方法,可作为VA狭窄筛选的常规检查手段.“,”Objective To investigate the clinical value of thin-slab curved planar reformation (CPR) maximun intensity projection (MIP) in the diagnosis of vertebral artery insufficiency of cervical spondylosis.Materials and Methods One hundred sixteen vertebral arteries were reconstructed by using thin-slab CPR MIP after 58 patients performed 64-slice CT scanning and the results were compared with DSA, which was used as a golden standard.The sensitivity, , pecificity, nega-tive predictive value, positive predicting value respectively.Results CTA agreed with DSA categorization of stenosis in 98 of the 116 arteries.When 70% of stenosis rate was used as the cut-off value, the sensitivity, specificity, negative pre-dictive value and the positive predicting value were 100% (19/19) , 96.9% (94/97) , 86.4% (19/22) , and 100%(94/94) respectively.When 50% of stenosis rate was used as the cut-off value, the sensitivity, specificity, negative pre-dictive value and the positive predicting value were 97.3% (36/37) , 94.9% (75/79) , 90% (36/40) , and 98.7% (75/76).Conclusion An excellent correlation and high accuracy were demonstrated between thin-slab CPR MIP and DSA on degree of stenosis.Thin-slab CPR MIP appears to be an excellent screening test for vertebral artery stenosis.