经颅多普勒超声与彩色多普勒血流显像联合应用对椎动脉狭窄的诊断价值  

Diagnostic Value of Combining CDFI with TCD in Vertebral Artery Stenosis

作　　者：奚克敏[1] 单叔煤[1] 李彩娟[1] 

机构地区：[1]牡丹江医学院附属红旗医院超声科,黑龙江牡丹江157011

出　　处：《中国医疗设备》2009年第5期118-119,128,共3页China Medical Devices

基　　金：黑龙江省卫生厅支持项目(2007-033)

摘　　要：目的评价经颅多普勒超声(TCD)与彩色多普勒血流显像(CDFI)联合诊断椎动脉(VA)狭窄的敏感性和特异性。方法对134例临床怀疑椎基底动脉供血不足患者行TCD和CDFI常规检查,其中34例患者确定为椎动脉狭窄或闭塞,通过CDFI对颅外段椎动脉的走形、管径、血流速度和阻力指数进行检测,通过TCD确定颅内椎基底动脉狭窄或闭塞的血液动力学改变。将TCD、CDFI及这两种方法联合应用的检查结果分别与脑血管造影(DSA)进行对比分析。结果DSA提示VA狭窄或闭塞为31支,阴性37支,CDFI、TCD和综合结果与DSA符合分别为60、59和67支,敏感性分别为87.1%、83.8%和100%,特异性分别为89.2%、89.1%和97.3%,准确率分别为88.2%、86.8%和98.5%。两者的综合结果明显提高了准确率(P<0.05)。结论TCD、CDFI的联合应用进一步提高了对椎动脉狭窄诊断的准确性,可以作为筛选椎动脉狭窄的首选方法。Objective To evaluate the sensitivity （SEN） and specificity （SPE） of combining color duplex imaging （CDI） with transeranial Doppler（TCD） in diagnosing vertebral artery stenosis（VBS）. Mothods 134 patients with vertebrobasilar insufficiancy（VBl） were examined by CDI and TCD. 34 cases （68 arteries） with vertebral artery stanosis were detected and confn＇med by digital subtraction angiography （DSA）. CDI could observe the vascular morphological changes and hemodynimics of vertebral artery.TCD helped to evaluate the hemobynamics of intracranial artery. The results of CDI, TCD and combination of two methods with DSA were compared by X^2 test. Results The DSA showed there were 31 stenosis or occlusion and 37 normal arteries of 68 VA. The sum of detecting stenosed or occluded VA by CDI, TCD and CDI plus TCD confirmed by DSA were 60, 59 and 67 arteries respectively. The SEN was 87.1%, 83.8% and 100%,SPE was 89.2%, 89.1% and 97.3% respectively. The OA was 88.2%, 86.8% and 98.5% respectively. The result of combining CDI with TCD had higher accuracy than CDI and TCD alone （P〈0.05）. Conclusion Combining CDI with TCD may provide higher accuracy in diagnosing vertebral artery stenosis.It can be used to be a general examination method for VBI.

关 键 词：经颅多普勒超声 彩色多普勒血流显像仪 椎动脉狭窄 

分 类 号：R445.1[医药卫生—影像医学与核医学]