TCD联合CDFI应用对颈内动脉狭窄的诊断价值  

Clinical value of TCD combined with CDFI in diagnosis of internal carotid artery stenosis

作　　者：苟显娜 赵丽莉[1] 陈黎艳 孙赛男 唐向东[1] GOU Xianna;ZHAO Lili;CHEN Liyan;SUN Sainan;TANG Xiangdong(Neurobiological Test Center,West China Hospital,Sichuan University,Chengdu 610041,Sichuan,China)

机构地区：[1]四川大学华西医院神经生物检测中心,四川成都610041

出　　处：《贵州医科大学学报》2021年第8期949-953,共5页Journal of Guizhou Medical University

基　　金：四川省卫生和计划生育委员会重点研究项目(19PJ043)。

摘　　要：目的探讨经颅多普勒超声(TCD)与彩色多普勒血流显像(CDFI)联合应用对颈内动脉狭窄的诊断价值。方法68例疑为颈动脉狭窄的缺血性脑血管疾病患者均经TCD、CDFI及数字减影血管造影(DSA)检测,记录DSA检出颈内动脉狭窄的数量、位置、类型及严重程度;以DSA的检查结果为金标准,将TCD、CDFI单一检查或联合检查结果与DSA检查比较的准确率、敏感度、特异度、阴性及阳性预测值。结果68例患者通过DSA检出双侧狭窄24例(35.3%)、单侧闭塞22例(32.4%)、单侧狭窄22例(32.4%),共检测血管136支,正常46支(33.8%)、颈内动脉狭窄血管90支[包括重度狭窄67支(49.2%)、闭塞23支(16.9%)];对比DSA检测结果,CDFI的准确率为96.7%,TCD的准确率为93.3%,CDFI联合TCD的准确率为97.8%,CDFI、TCD二者联合检测的病变检出率高于单一的CDFI或TCD检测,但差异无统计学意义(P>0.05);CDFI、TCD二者联合检测的准确率、敏感度、特异度、阳性、阴性预测值高于CDFI或TCD单独检测,差异有统计学意义(P<0.05)。结论TCD联合CDFI检查,可显著提高临床中对颈内动脉闭塞或狭窄的缺血性脑血管疾病患者诊断准确率。Objective To investigate the clinical value of combining transcranial Doppler ultrasound(TCD)and color Doppler flow imaging(CDFI)in diagnosis of internal carotid artery stenosis.Methods Sixty-eight patients with ischemic cerebrovascular disease suspected of carotid artery stenosis were tested by TCD,CDFI,and digital subtraction angiography(DSA).DSA tested counts,locations,types,and severity of internal carotid artery stenosis were recorded.The results of DSA were used as gold standard,comparing the results of TCD,CDFI,and combined test with that of DSA for accuracy,sensitivity,specificity,negative,and positive predictive values.Results A total of 136 blood vessels were tested by DSA in 68 patients,46 of which were normal(33.8%);90 vessels of internal carotid artery stenosis[including 67(49.2%)severe stenosis and 23 occlusion(16.9%)];24 cases of bilateral stenosis(35.3%),22 cases of unilateral occlusion(32.4%),and 22 cases(32.4%)of unilateral stenosis.Comparing the results of DSA testing,the accuracy of CDFI was 96.7%,the accuracy of TCD was 93.3%,and the accuracy of CDFI combined with TCD was 97.8%.Detection rate of CDFI combined with TCD detection was higher than using CDFI or TCD alone,but differences were not statistically significant(P<0.05).The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of CDFI combined with TCD test were significantly higher than the results of CDFI and TCD test alone(P<0.05).Conclusion TCD combined with CDFI examination can significantly improve the diagnostic accuracy of carotid artery occlusion or stenosis with internal carotid artery stenosis in clinical practice.

关 键 词：超声检查 多普勒 血管造影术 数字减影 颈内动脉 脑动脉 彩色多普勒血流显像 血管狭窄 

分 类 号：R445.1[医药卫生—影像医学与核医学] R743[医药卫生—诊断学]