颈动脉粥样硬化超声与血管造影的对比研究  

Comparative study of carotid artery ultrasound with angiography in patients with carotid atheriusclerusis

作　　者：裴林林[1] 陈庆伟[1] 王志刚[2] 吴庆[1] 柯大智[1] 李桂琼[1] 

机构地区：[1]重庆医科大学附属第二临床学院老年病科,400010 [2]重庆医科大学附属第二临床学院影像研究所,400010

出　　处：《中华超声影像学杂志》2007年第4期306-309,共4页Chinese Journal of Ultrasonography

摘　　要：目的 探讨超声与血管造影诊断颈动脉粥样硬化的优劣。方法 对80例有两项以上动脉粥样硬化危险因素的患者行颈动脉超声及数字减影血管造影检查，观察动脉管腔内径，颈动脉内膜-中层厚度，有无斑块及其性质、部位，有无狭窄并计算狭窄率。结果 颈动脉斑块的总体发病率左侧高于右侧，斑块部位以颈总动脉分叉处最多见，其次为颈总动脉主干及颈内动脉。超声与造影对颈动脉斑块和（或）狭窄的总体检出率分别为78．1％和73．8％；诊断颈动脉狭窄率分别为（43．5±0．6）％和（46．5±0．7）％（P〉0．05）。以血管造影为诊断参照标准，超声诊断颈动脉粥样硬化的敏感性、特异性、阳性预测值、阴性预测值分别为91．07％、63．64％、86．44％和73．68％。结论 超声诊断颈动脉粥样硬化的敏感性高，特异性偏低，但对颈动脉粥样斑块检出率高于血管造影，联合应用颈动脉造影对其病因、诊断、临床治疗及术前评估与术后随访意义重大。Objective To compare the advantages and shortcoming of carotid artery ultrasound with digital subtraction angiography（DSA） of carotid in diagnosis of carotid atheriosclerosis. Methods A total of 80 patients with more than two dangerous factors of carotid atheriosclerosis were examed with carotid artery ultrasound and carotid DSA. The inside diameter, intima-media thickness of carotid artery, character and positon of plaque,stenosis were observed and the ratio of stenosis was calculated. Results The incidence of the left carotid plaque was higher than that of the right. The most plaques of the bifurcation of carotid artery were found than the others. The plaques of main carotid and interior carotid artery were secondary. The incidence of plaque and（or） stenosis of carotid in aged patients diagnosed by ultrasound and DSA were 78.1%,73.8%, respectively. The ratio of stenosis with carotid artery ultrasound and carotid DSA were （43.5 ± 0.6） % and （46.5 ± 0.75） %, respectively. Taking DSA as a golden standard, the sensitivity, specificity,positive predictive value, negative predictive value of carotid artery ultrasound was 91.07%, 63.64%, 86.44%, 73.68%, respectively. Conclusions Carotid artery ultrasound has high sensitivity in diagnosis of carotid atheriosclerosis, but specificity is lower. Either carotid artery ultrasound or DSA has advantages and shortcoming. If combinated the two methods, there will be an important significance in diagnosis,clinical treatment, observation before operation and follow-up after operation in patients with carotid atheriosclerosis.

关 键 词：超声检查 颈动脉 动脉硬化 血管造影术 数字减影 

分 类 号：R686[医药卫生—骨科学]