经颅多普勒超声联合颈动脉超声检查对椎-基底动脉狭窄的诊断价值  

Clinical value of transcranial Doppler ultrasonography combined with carotid ultrasonography in the diagnosis of vertebral-basilar artery stenosis

作　　者：王洁 Wang Jie(Department of Ultrasound,the People's Hospital of Zhuji,Zhuji,Zhejiang 311800,China)

机构地区：[1]诸暨市人民医院超声科,浙江省311800

出　　处：《中国基层医药》2020年第7期786-790,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的:探讨经颅多普勒超声(TCD)联合颈动脉超声检查对椎-基底动脉狭窄的临床诊断价值。方法:选择2016年3月至2018年12月诸暨市人民医院收治的高度怀疑为椎-基底动脉狭窄患者147例,对患者进行TCD联合颈动脉超声检查,同时进行X线电子计算机断层扫描血管成像(CTA)检查,以CTA检查结果为金标准,分析TCD联合颈动脉超声检查对椎-基底动脉狭窄诊断的准确率。结果:以CTA检查为诊断金标准,分析TCD联合颈动脉超声检查对椎-基底动脉狭窄的诊断价值,对左侧椎动脉诊断灵敏度86.42%、特异度89.39%、阳性预测值90.91%、阴性预测值84.29%;对右侧椎动脉诊断灵敏度80.26%、特异度90.14%、阳性预测值89.71%、阴性预测值81.01%;对基底动脉诊断灵敏度81.69%、特异度93.42%、阳性预测值92.06%、阴性预测值84.52%。TCD联合颈动脉超声检查与CTA对左侧椎动脉、右侧椎动脉及基底动脉狭窄程度诊断比较差异均无统计学意义( Z=-0.360、-0.851、-0.828,均 P>0.05)。 结论:TCD联合颈动脉超声检查作为椎-基底动脉狭窄患者的有效筛查手段,有助于患者病情的检测以及指导临床治疗。Objective To investigate the clinical value of transcranial Doppler ultrasound(TCD)combined with carotid ultrasound in the diagnosis of vertebral-basilar artery stenosis.Methods From March 2016 to December 2018,147 patients with suspected vertebrobasilar artery stenosis admitted to the People's Hospital of Zhuji were selected.TCD combined with carotid artery ultrasonography were used to diagnose vertebrobasilar artery stenosis,and X-ray computed tomography angiography(CTA)was performed.The diagnostic accuracy of TCD combined with carotid artery ultrasonography for vertebrobasilar artery stenosis was analyzed based on the results of CTA.Results The diagnostic value of TCD combined with carotid ultrasound for vertebrobasilar artery stenosis was analyzed by using CTA as diagnostic gold standard.The diagnostic sensitivity for left vertebral artery was 86.42%,specificity was 89.39%,positive predictive value was 90.91%,negative predictive value was 84.29%.The diagnostic sensitivity for right vertebral artery was 80.26%,specificity was 90.14%,positive predictive value was 89.71%,negative predictive value was 81.01%.The sensitivity,specificity,positive predictive value and negative predictive value for basilar artery were 81.69%,93.42%,92.06%and 84.52%.respectively.There were no statistically significant differences between TCD combined with carotid ultrasound and CTA in the diagnosis of left vertebral artery,right vertebral artery and basilar artery stenosis(Z=-0.360,-0.851,-0.828,all P>0.05).Conclusion TCD combined with carotid ultrasonography is an effective screening method for patients with vertebrobasilar artery stenosis,which is helpful to the detection of patients'condition and the guidance of clinical treatment,and is worthy of clinical application.

关 键 词：超声检查 多普勒 经颅 超声检查 多普勒 彩色 基底动脉 椎动脉 颈动脉 X线电子计算机断层扫描血管成像 颅内动脉粥样硬化性狭窄 

分 类 号：R74[医药卫生—神经病学与精神病学]