摘要
目的探讨彩色多普勒血流显像(CDFI)诊断中国人颈动脉狭窄性病变的血流动力学参数标准及准确性。方法应用CDFI检测416例颈动脉狭窄性病变患者的颈总动脉远段、颈内动脉狭窄段、狭窄远段血管(共832支)的收缩期峰值流速(PSVCCA、PSVICA、PSVDIS)和颈内动脉狭窄段、狭窄远段血管舒张期末流速(EDVICA、EDVDIS),以DSA检查结果为标准计算PSVICA/PSVCCA、PSVICA/PSVDIS、EDVICA/EDVDIS及受试者特征(ROC)曲线下面积,比较上述各参数在不同取值下的敏感性、特异性及准确性,并与以往文献中推荐的CDFI诊断标准进行比较。结果①诊断颈动脉50%～69%狭窄的参数标准依次为PSVICA≥155cm/s、EDVICA≥60cm/s、PSVICA/PSVCCA≥2.0、PSVICA/PSVDIS≥1.6。70%～99%狭窄的参数选择是PSVICA≥220cm/s、EDVICA≥100cm/s、PSVICA/PSVCCA≥3.5、PSVICA/PSVDIS≥3.5。②联合采用PSVICA、EDVICA、PSVICA/PSVDIS或PSVICA、EDVICA、PSVICA/PSVCCA参数标准,CDFI诊断颈动脉狭窄50%～69%和70%～99%与DSA的符合率,分别为95.5%、92.9%和96.4%、93.9%。③PSVICA/PSVDIS比值对于颈动脉70%～99%狭窄病变的准确率(91.1%)高于PSVICA/PSVCCA(90.8%)。结论PSVICA、EDVICA、PSVICA/PSVDIS、PSVICA/PSVCCA是评估颈动脉狭窄程度准确的多普勒血流动力学参数。各参数联合可以进一步提高诊断准确率。
Objective To discuss hemodynamic parameter criteria and their accuracy in diagnosing carotid stenotic lesions in patients with color Doppler flow imaging （CDFI）. Methods The peak systolic velocity （PSVCCA, PSVIC, PSVDIS） and end-diastolic flow velocity （EDVICA, EDVDIS） in 416 patients with carotid stenotic lesion on distal common carotid arteries, stenotic segments of the internal carotid artery, and stenotic distal arteries （832 arteries） were detected by using CDFI. Using the results of digital subtraction angiography （DSA） as criteria, PSVICA//PSVCCA, PSVICA//PSVDIS, EDVICA/EDVDIS and receiveroperator characteristic （ROC） area under the curve were calculated. The sensitivity, specificity and overall accuracy of the above parameters under the different values were compared, and they were also compared with the recommended CDFI diagnostic criteria in the previous literatures. Results The parameter criteria for diagnosing 50%-69% stenoses were in order of PSVICA ≥ 155 cm/s, EDVICA ≥60 cm/s, PSVICA/ PSVccs ≥2. 0, and PSVICA/PSVDIS 91.6; the parameter selection of 70%-99% stenoses were PSVICA 220 cm/s, EDVICA ≥ 100 cm/s, PSVICA/PSVCCA ≥ 3.5, and PSVICA/PSVDIS ≥ 3.5. The combination of PSVICA/ EDVICA, PSVICA/PSVCCA or PSVICA, EDVICA, and PSVICA/PSVDIS improved the diagnostic accordance rate of 50% -69% or 70% -99% carotid stenoses and DSA ; they were 95.5%, 92. 90/0,96. 40/0, and 93.9%, respectively. The accuracy （91.1%） of PSVICA/PSVDCCA odds for 70%-99% carotid stenotic lesions was higher than PSVICA/PSVCCA. Conclusion PSVICA, EDVICA, PSVIGA/ PSVDIS, and PSVICA/PSVCCA are the aceurate hemodynamic panuneters in assessing the severity of carotid stenosis,and the combination of these pammeters may improve the aceuracy of diagnosis.
出处
《中国脑血管病杂志》
CAS
2006年第5期211-218,共8页
Chinese Journal of Cerebrovascular Diseases
