超声造影检查在颈动脉狭窄诊断及治疗指导中的应用价值  

The application value of ultrasonography in the diagnosis and guidance of treatment for carotid artery stenosis

作　　者：齐尧[1] 李竞[1] 张立春[1] 孙锐[1] 梅丽霞[1] 敬子洋[1] 王勇[1] 李甜甜[1] 张旸[1] QI Yao;LI Jing;ZHANG Li-chun(Department of Ultrasound, The First Hospital of Qiqihar City, Qiqihar 161000, China)

机构地区：[1]齐齐哈尔市第一医院超声科,黑龙江齐齐哈尔161000

出　　处：《中国医学装备》2017年第10期65-68,共4页China Medical Equipment

基　　金：黑龙江省卫生计生委科研课题(2016-406)"超声造影对颈动脉及椎动脉狭窄病变的诊断分析"

摘　　要：目的:探讨超声造影检查技术在颈动脉狭窄诊断及治疗中的应用价值。方法:选取在医院接受数字减影血管造影(DSA)确诊的82例颈动脉狭窄患者,所有患者在DSA检查前1周接受超声造影及常规超声检查,以DSA诊断结果作为金标准,研究超声造影及常规超声检查在颈动脉狭窄诊断及治疗指导中的应用意义。结果:超声造影检查对于颈内动脉狭窄的诊断准确率明显高于常规超声检查,两种检查方法比较差异有统计学意义(x^2=7.829,P<0.05);但常规超声与超声造影对颈总动脉、颈内动脉狭窄程度判断准确率均无统计学意义(x^2=0.415,x^2=0.729;P>0.05);不同狭窄程度颈动脉斑块超声造影增强程度比较具有统计学意义(F=8.372,P<0.05)。在超声造影增强程度与狭窄程度的相关性比较中,狭窄程度在>90%与<90%的颈动脉斑块超声造影分级具有统计学意义(x^2=5.732,P<0.05);但狭窄程度<90%斑块的超声造影增强分级比较,差异无统计学意义(F=0.973,P>0.05)。结论:超声造影应用诊断颈动脉狭窄具有较高的准确率,尤其是对于颈内动脉狭窄的诊断及对狭窄程度评估更为理想,同时还可根据超声造影斑块内增强程度分级初步评估患者动脉狭窄病情,为临床治疗方案提供指导依据。Objective:To explore the application value of ultrasonography in the diagnosis and treatment for patientswith carotid artery stenosis.Methods:82patients with carotid artery stenosis who were confirmed by using digitalsubtraction angiography(DSA)received routine ultrasound and contrast-enhanced ultrasonography,respectively,before1week of the detection of DSA.And the results of DSA were used as gold standard to research the applicationsignificant of the two detection methods in diagnosis and treatment for patients with carotid artery stenosis.Results:The accuracy rate of diagnosis for internal carotid artery stenosis of contrast-enhanced ultrasonographywas significantly higher than that of routine ultrasound(x2=7.829,P<0.05).While the difference of diagnosticdegrees for arteria carotis communis and internal carotid artery stenosis between routine ultrasound and contrastenhancedultrasonography was no significant(x2=0.415,x2=0.729,P>0.05).The differences of contrast-enhancedultrasonography of carotid artery among different stenosis degree was significant(F=8.372,P<0.05).In the correlationanalysis between contrast-enhanced ultrasonography and stenosis degree,the differences of ultrasonography grades ofcarotid plaque between two stenosis degrees(one was higher than90%,and other was lower than90%)was significant(x2=5.732,P<0.05).When stenosis degree was lower than90%,the differences among different grades of contrastenhancedultrasonography was no significant(F=0.973,P>0.05).Conclusion:There is higher accuracy rate whenultrasonography is applied in the diagnosis of carotid artery stenosis,especially in the diagnosis of internal carotidartery stenosis and the evaluation of stenosis degree,the effect is more ideal.At the same time,the situation of arterystenosis of patients can be preliminary assessed according to the grades of the enhanced degree in the ultrasoundcontrast lump,and it can provide basis of guidance for clinical therapeutic schedule.

关 键 词：超声造影 颈动脉狭窄 狭窄程度 诊断价值 治疗评估 

分 类 号：R445.1[医药卫生—影像医学与核医学]