颈部血管超声对脑梗死合并颈动脉狭窄病变的诊断价值  

Diagnostic value of cervical vascular ultrasound in cerebral infarction with carotid stenosis

作　　者：李筱梅[1] 刘娟萍[2] 钟群锋[1] LI Xiao-mei;LIU Juan-ping;ZHONG Qun-feng(Department of Ultrasound,Xingguo County People′s Hospital,Jiangxi Province,Xingguo342400,China;Department of Ultrasound,Jishui County People′s Hospital,Jiangxi Province,Jishui331600,China)

机构地区：[1]江西省兴国县人民医院超声科,江西兴国342400 [2]江西省吉水县人民医院超声科,江西吉水331600

出　　处：《中国当代医药》2020年第27期132-134,共3页China Modern Medicine

基　　金：江西省赣州市指导性科技计划项目(GZ2019ZSF 455)。

摘　　要：目的探讨颈部血管超声对脑梗死合并颈动脉狭窄病变的诊断价值。方法选取2019年1月~2020年1月在兴国县人民医院就诊的80例脑梗死合并颈动脉狭窄病变患者为研究对象,采用数字减影血管造影检查和颈动脉血管超声进行检查。以数字减影血管造影检查为金标准,比较颈动脉血管超声颈动脉硬化、斑块的检出情况,评价颈动脉血管超声在轻度、中度、重度狭窄及闭塞血管诊断中的灵敏度、特异度、准确度。结果颈动脉血管超声的动脉硬化检出率、斑块检出率与数字减影血管造影检查比较,差异无统计学意义(P>0.05)。数字减影血管造影狭窄检出情况中,80例患者共检查出114支颈动脉,其中轻度狭窄22支,中度狭窄21支,重度狭窄21支,完全闭塞22支。颈动脉血管超声检查轻度狭窄16支,中度狭窄13支,重度狭窄20支,完全闭塞22支。颈动脉血管超声检查轻度狭窄、中度狭窄、重度狭窄以及完全闭塞的诊断灵敏度为63.64%、57.14%、85.71%、90.91%,特异度为97.83%、98.92%、97.85%、97.83%,准确度为91.23%、91.23%、95.61%、96.49%,均超过90%。结论颈部血管彩超检查应用于脑梗死合并颈动脉狭窄病变诊断中的临床价值较高,其诊断特异性、准确性均较高,可有效判断颈动脉狭窄程度及脑梗死闭塞情况,有利于脑梗死合并颈动脉狭窄病变高危人群的检查。Objective To explore the diagnostic value of cervical vascular ultrasound in cerebral infarction with carotid stenosis.Methods A total of 80 patients with cerebral infarction and carotid stenosis who were treated in Xingguo County People′s Hospital from January 2019 to January 2020 were selected as the research subjects.The patients were given digital subtraction angiography and carotid vascular ultrasound examination.Using digital subtraction angiography as the gold standard,the detection of atherosclerosis and plaque by carotid vascular ultrasound examination was compared,and the sensitivity,specificity and accuracy of carotid artery ultrasound in the diagnosis of mild,moderate,severe stenosis and occlusive vessels were evaluated.Results There was no significant difference in the detection rate of atherosclerosis and plaque between carotid vascular ultrasound and digital subtraction angiography(P>0.05).Among the stenosis detected by digital subtraction angiography,114 cases of carotid arteries were detected in 80 patients,including 22 cases with mild stenosis,21 cases with moderate stenosis,21 cases with severe stenosis and 22 cases with complete occlusion.Carotid artery ultrasound examination showed 16 cases were mild stenosis,13 cases were moderate stenosis,20 cases were severe stenosis,and 22 cases were complete occlusion.The sensitivity of carotid artery ultrasound in the diagnosis of mild stenosis,moderate stenosis,severe stenosis and complete occlusion were 63.64%,57.14%,85.71%,90.91%,respectively,the specificity were 97.83%,98.92%,97.85%,97.83%,and the accuracy were 91.23%,91.23%,95.61%and 96.49%,all over 90%.Conclusion The application of cervical vascular ultrasound in the diagnosis of cerebral infarction combined with carotid stenosis is of high clinical value,with high specificity and accuracy.It can effectively judge the degree of carotid stenosis and the occlusion of cerebral infarction,which is conducive to the examination of high-risk group of cerebral infarction combined with carotid stenosis.

关 键 词：颈部血管彩超 数字减影血管造影 脑梗死 颈动脉狭窄病变 诊断 临床价值 

分 类 号：R445.1[医药卫生—影像医学与核医学]