摘要
目的 评价单纯双功能彩超 (CDI)、经颅多普勒超声 (TCD)对颈内动脉 (ICA)狭窄 (≥ 70 % )或闭塞诊断的准确率、敏感性和特异性。方法 对 5 6 9例缺血性脑血管患者行CDI和TCD常规检测 ,其中 38例患者(76支动脉 )确定为单侧或双侧ICA狭窄或闭塞 ,经脑血管造影检测证实。通过CDI对颅外段ICA残余管径、峰值流速 (PSV)和舒张末流速 (EDV)的检测 ,TCD对颅内Willi’s环动脉的检测 ,确定ICA狭窄或闭塞的形态学和血流动力学改变 ,将CDI、TCD及两者综合诊断结果分别与脑血管造影 (DSA)对比分析。结果 DSA提示ICA狭窄≥ 70 %为 30支 ,闭塞 2 1支 ,阴性 2 5支。CDI、TCD和综合结果与DSA符合分别为 6 7、6 3和 75支 ,敏感性分别为 89.6 %、88.6 %、98.1% ,特异性 85 .7%、75 .0 %和 10 0 % ,准确率 88.2 %、82 .9%和 98.7% ;两者的综合结果明显提高了准确率 (P <0 .0 1)。结论 CDI和TCD的联合应用提高了对重度ICA狭窄或闭塞的诊断准确性 。
Objective To evaluate the sensitivity(SEN),specificity(SPE) and overall accuracy(OA) of color duplex imaging(CDI),transcranial Doppler(TCD)and result of concordant CDI and TCD in diagnosing severe stenosis(≥70%) or occlusion of internal carotid artery(ICA).Methods Five hundred and sixtynine patients with ischemic cerebrovascular disease were examined by CDI and TCD.Thirtyeight cases (76 arteries) with unilateral or bilateral stenosis or occlusion of ICA were detected and confirmed by digital subtraction angiography(DSA).CDI facilitates the determination of residual lumen,PSV and EDV of ICA and TCD helps the evaluation of the hemodynamics of intracranial artery.The results of CDI, TCD and combination of two method with DSA were compared by χ2 test.Results The DSA showed there were 30 stenosis,21 occlusion and 25 normal arteries of 76 ICA.The sum of detecting stenosed or occluded ICA by CDI,TCD and CDI plus TCD confirmed by DSA were 67,63 and 75 arteries, respectively. The SEN was 89.6% , 88.6% and 98.1 % ;SPE was 85.7% , 75.0 % and 100% respectively. The OA was 88.2 %, 82.9 % and 98.7 %,respectively.The result of combining CDI and TCD has significantly higher accuracy than CDI and TCD alone (P< 0.01 ).Conclusions Combining CDI and TCD two noninvasive method may provides a higher accuracy in diagnosing severe carotid atherosclerosis diseases and more choices in clinic treatment.
出处
《中华超声影像学杂志》
CSCD
2000年第7期413-415,共3页
Chinese Journal of Ultrasonography
