彩色多普勒超声与DSCTA评价颈动脉狭窄的对比研究  

Comparative study of color Doppler ultrasound and dual source CTA in assessment of carotid artery stenosis

作　　者：管林军[1] 熊华花[1] 黄珊珊[1] 李振洲[1] GUAN Linjun;XIONG Huahua;HUANG Shanshan;LI Zhenzhou(Department of Ultrasound,the First Affiliated Hospital of Shenzhen University,Shenzhen 518035,China)

机构地区：[1]深圳大学第一附属医院深圳市第二人民医院超声科,深圳市518035

出　　处：《临床超声医学杂志》2018年第7期453-456,共4页Journal of Clinical Ultrasound in Medicine

基　　金：深圳市科技计划项目(JCYJ20170306092258717)

摘　　要：目的对比分析彩色多普勒超声与DSCTA在评价颈动脉狭窄(CAS)病变程度中的应用价值。方法选取CAS患者80例(共296条血管节段),于1周内分别行彩色多普勒超声和DSCTA检查,以DSA检查结果为"金标准",对比分析彩色多普勒超声和DSCTA的诊断效能。结果两种检查方法对不同程度CAS的检出情况比较差异均无统计学意义(χ2=7.248,P=0.362)。彩色多普勒超声诊断轻度狭窄的敏感性为85.56%,特异性为92.32%,诊断符合率94.11%,与DSA的一致性高(Kappa=0.869);DSCTA的敏感性为89.12%,特异性为93.44%,诊断符合率93.75%,与DSA的一致性高(Kappa=0.879)。彩色多普勒超声诊断中度狭窄的敏感性为87.88%,特异性为93.48%,诊断符合率90.00%,与DSA的一致性高(Kappa=0.895);DSCTA的敏感性为94.03%,特异性为97.50%,诊断符合率95.00%,与DSA的一致性高(Kappa=0.916)。彩色多普勒超声诊断重度狭窄的敏感性为88.92%,特异性为92.35%,诊断符合率88.89%,与DSA的一致性高(Kappa=0.857);DSCTA的敏感性为93.86%,特异性为96.23%,诊断符合率94.44%,与DSA的一致性高(Kappa=0.908)。彩色多普勒超声诊断管腔闭塞的敏感性为85.74%,特异性为87.42%,诊断符合率75.00%,与DSA的一致性高(Kappa=0.792);DSCTA的敏感性为89.83%,特异性为88.95%,诊断符合率87.50%,与DSA的一致性高(Kappa=0.825)。结论彩色多普勒超声与DSCTA均能准确评估CAS病变程度,彩色多普勒超声因具有快速、简便、无创及可重复性好的优点,可作为临床筛查CAS的首选方法;而DSCTA更适用于进一步明确诊断。Objective To assess the application value of color Doppler ultrasound and dual source CTA(DSCTA)in the assessment of carotid artery stenosis.Methods Eighty patients with carotid stenosis(CAS)including 296 segments were selected,they were underwent color Doppler ultrasound and DSCTA within one week.The diagnostic efficiency of color Doppler ultrasound and DSCTA were comparatively analyzed with the results of DSA as a golden standard.Results There was no significant difference between two methods in the diagnosis of CAS with different degree(χ2=7.248,P=0.362).When they were used to check for mild stenosis,the sensitivity,specificity and diagnostic accordance rate of color Doppler ultrasound were 85.56%,92.32%and 94.11%,respectively,with Kappa value was 0.869,the sensitivity,specificity and diagnostic accordance rate of DSCTA were 89.12%,93.44%and 93.75%,respectively,with Kappa value was 0.879.When they were used to check for moderate stenosis,the sensitivity,specificity and diagnostic accordance rate of color Doppler ultrasound were 87.88%,93.48%and 90.00%,respectively,with Kappa value was 0.895,the sensitivity,specificity and diagnostic accordance rate of DSCTA were 94.03%,97.50%and 95.00%,respectively,with Kappa value was 0.916.When they were used to check for severe stenosis,the sensitivity,specificity and diagnostic accordance rate of color Doppler ultrasound were 88.92%,92.35%and 88.89%,respectively,with Kappa value was 0.857,the sensitivity,specificity and diagnostic accordance rate of DSCTA were 93.86%,96.23%and 94.44%,respectively,with Kappa value was 0.908.When they were used to check for lumen occlusion,the sensitivity,specificity and diagnostic accordance rate of color Doppler ultrasound were 85.74%,87.42%and 75.00%,respectively,with Kappa value was 0.792,the sensitivity,specificity and diagnostic accordance rate of DSCTA were 89.83%,88.95%and 87.50%,respectively,with Kappa value was 0.825.Conclusion Color Doppler ultrasound and DSCTA can accurately assess the extent of CAS with good consistency.Color D

关 键 词：超声检查 多普勒 彩色 血管造影 颈动脉狭窄 脑梗死 缺血性 

分 类 号：R543.4[医药卫生—心血管疾病] R445.1[医药卫生—内科学]