彩超直径法和血流速度法评价颈动脉狭窄的临床价值研究  

Clinical significance of color Doppler ultrasound with diameter standard or blood flow velocity standard in evaluating carotid artery stenosis

作　　者：樊文峰[1] 刘文聪[1] 刘文宣[2] 时军[1] 顾平[3] 张振清[3] 

机构地区：[1]河北医科大学第一医院超声科,石家庄市050031 [2]河北医科大学公共卫生学院流行病与卫生统计学教研室 [3]河北医科大学第一医院神经内二科,石家庄市050031

出　　处：《河北医药》2016年第10期1468-1470,1474,共4页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题(编号:20130270)

摘　　要：目的探讨彩超直径法和血流速度法不同的两种方法评估颈动脉狭窄的准确性和临床价值。方法通过彩色多普勒超声检查分别用直径法和血流速度法诊断颈动脉狭窄51例,评估其程度,并与数字减影血管造影(DSA)作对照,评价彩超两种方法的符合率及其诊断的准确性。结果直径法灵敏度(Se)95.35%,假阴性率4.65%,特异度(Sp)75%,假阳性率25%,阳性似然比(LR+)3.81,阴性似然比(LR-)0.06,约登指数0.70。流速法灵敏度(Se)97.67%,假阴性率2.33%,特异度(Sp)87.5%,假阳性率12.5%,阳性似然比(LR+)7.81,阴性似然比(LR-)0.03,约登指数0.85。结论彩超血流速度法和直径法诊断颈动脉狭窄二者有较高的符合率,血流速度法比直径法有较高的灵敏度、特异度和约登指数。Objective To investigate the accuracy and clinic significance of color Doppler ultrasound with diameter standard or blood flow velocity standard in evaluating carotid artery stenosis. Methods Fifty- one patients with carotid artery stenosis were examined by color Doppler ultrasound with diameter standard or blood flow velocity standard to evaluate severity of disease,moreover,the examination results were compared with those of digital subtraction angiography（ DSA） to evaluate diagnostic accuracy and coincidence rate of both methods. Results In diagnosis of carotid artery stenosis by color Doppler ultrasound with diameter standard,the sensitivity was 95. 35%,false negative rate 4. 65%,specificity 75%,false positive rate 25%,positive likelihood ratio 3. 81,negative likelihood ratio 0. 06,Youden index 0. 70,however,which by color Doppler ultrasound with blood flow velocity was 97. 67%,2. 33%,87. 5%,12. 5%,7. 81,0. 03,0. 85,respectively. Conclusion The coincidence rate of color Doppler ultrasound with diameter standard and blood flow velocity standard in diagnosis of carotid artery stenosis is quite higher,furthermore,the color Doppler ultrasound with blood flow velocity standard is superior to color Doppler ultrasound with diameter standard in sensitivity,specificity and Youden index.

关 键 词：超声检查 直径 血流速度 数字减影血管造影 颈动脉狭窄 

分 类 号：R445.14[医药卫生—影像医学与核医学]