Efficiency of CTA Combined with CVUS on Guiding the Evaluation of Carotid Artery Stenosis in Patients with Ischemic Stroke

YANG Siyao

doi:10.14033/j.cnki.cfmr.2025.21.017

Abstract：Objective:To explore the efficiency of CT angiography(CTA)combined with cervical vascular ultrasound(CVUS)on guiding the evaluation of carotid artery stenosis in patients with ischemic stroke.Method:From October 2023 to October 2024,126 patients with ischemic stroke were enrolled Shijingshan Teaching Hospital,Capital Medical University,and received CTA and CVUS.With digital subtraction angiography(DSA)as the gold standard for diagnosis,the accuracy of CTA and CVUS alone and in combination in the diagnosis of carotid artery stenosis was analyzed,and the efficiency of CTA and CVUS alone and in combination in diagnosing moderate and above carotid artery stenosis was compared.Result:The accuracy rate of CTA was 68.00%(17/25)in the diagnosis of mild stenosis,was 81.63%(40/49)for moderate stenosis,was 85.37%(35/41)for severe stenosis,and was 72.73%(8/11)for occlusion,and the coincidence rate with DSA was 79.37%(100/126).The accuracy rate of CVUS was 64.00%(16/25)for mild stenosis,was 81.63%(40/49)for moderate stenosis,was 82.93%(34/41)for severe stenosis,and was 63.64%(7/11)for occlusion,and the coincidence rate with DSA was 76.98%(97/126).The accuracy rate of CTA combined with CVUS was 88.00%(22/25)in the diagnosis of mild stenosis,was 85.71%(42/49)for moderate stenosis,was 95.12%(39/41)for severe stenosis and was 90.91%(10/11)for occlusion,and the coincidence rate with DSA was 89.68%(113/126).There was no significant difference in the accuracy rates of CTA and CVUS alone or in combination in the diagnosis of different degrees of stenosis(P>0.05).The coincidence rate of the two combined examinations was higher than that of single examination(P<0.05).The sensitivity of CTA combined with CVUS in the diagnosis of moderate carotid artery stenosis and above was higher than single examination and the missed diagnosis rate was lower than single examination,the difference was statistically significant(P<0.05).There was no statistically significant difference in specificity and misdiagnosis rate(P>0.05).Conclusion:The combination of CTA and CVUS can effectively enhance the coincidence and sensitivity in the diagnosis of carotid artery stenosis in patients with ischemic stroke,and can provide a solid reference for the follow-up treatment of patients,and it has important application value.