| Objective To analysis the imaging features of the 64-MSCTA,to explore the clinical value of the 64-MSCTA in the preoperative etiological diagnosis for neurovascular compression patients in the artery stenosis of head and neck.Materials and Methods Collected from 50 cases of ischemic cerebrovascular disease who underwent 64-MSCTA and DSA examination within one week after another. 140 arteries were collected,and all kinds of reconstruction techniques were used to rebuild the images,which are used to display cases of artery branch points by 1-4 score. The arteries were divided into groups by the vascular lesions which were same or no,and reconstruction techniques were compared.Compared the results of patients'examination who underwent the 64-MSCTA and DSA,to assess 64-MSCTA diagnostic SEN,SPE,CON,PPR,NPR, crude agreement,adjust the consistency and the Youden index analysis.Resultâ‘ 140 arteries,of which 60 arteries head,neck arteries 80,were selected and reconstructed. After arteries were rebuild, it suggest that the method of MPR,43 arteries get the score of 4,54 arteries get the score of 3,38 arteries get the score of 2 ,5 arteries get the score of 1,the method of MIP reconstruction suggest that 96 arteries get the score of 4,25 arteries get the score of 3,18 arteries get the score of 2,and only 1 artery get the score of 1; and the method of VR reconstruction suggest that 88 arteries get the score of 4,27 arteries get the score of 3,24 arteries get the score of 2,only1 arteriy get the score of 1. Compared with DSA, the coincidences of MPR,MIP,VR in head are 80.00% ,91.67%,93.33%; and the coincidences of MPR, MIP,CPR,VR in the neck are 87.50%,91.25%,97.50%,93.75%.Compared the reconstructions,VR and MIP is better to use in head,and CPR,VR and MIP is better for neck.â‘¡The examination of 668 arteries compare with the result of DSA,628 arteries stenosis diagnosis were same with the result of DSA examination,the overall compliance rate was 94.01% (628/668),the Kappa is 0.813 (p <0.05).The 64-MSCTA for various levels of SEN,SPE,CON,PPV,NPV,in the mild stenosis were: 77.55%,99.42%,97.53%,92.68%,97.91%;medium:70.00%,99.82%,97.85%,96.55%,97.92%; severe degree: 75.00%,99.51%,98.13%,90.00%,98.53%; occlusion: 86.96%,99.84%,99.40%,95.24%,99.54%. Consistency of the various narrow and some board-level adjustment indices were: mild 91.89%,0.77; moderate 97.85%,0.70; moderate and severe 90.76%,0.75,occlusion of 95.39%,0.87.Conclusion The 64-MSCTA is able to display accurately display artery, and using a combination of various reconstruction methods can accurately display three or more small branches. To improve the efficiency of the 64-MSCTA examination, VR and MIP are the best reconstruction in head. VR,CPR and MIP are the best reconstruction in neck .The method of MPR can be appropriate for the local presence combined with artery lesions and display the situation of artery ,and improve the efficiency of diagnosis.64-MSCTA can be used in evaluate the artery stenosis judgment,and have a high degree of consistency with DSA,but also the efficiency in diagnosing the severity and the increase rate of the stenosis. It can be used at the clinical artery stenosis of head and neck,and will help the patients who under take the DSA examination to reduce the pain.
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