基于颅外段椎动脉频谱快速傅里叶分析评估颅内段椎动脉轻中度狭窄的研究  

Analysis of Extracranial Vertebral Arterial Doppler Waveform by Fast-Fourier Transform for Analysis of Mild to Moderate Intracranial Vertebral Artery Stenosis

作　　者：方永涵 熊华花[1] 张湘栋 吴丹[2] 邹霞[1] 张燕婷 裴思蝶 Fang Yonghan;Xiong Huahua;Zhang Xiangdong;Wu Dan;Zou Xia;Zhang Yanting;Pei Sidie(Department of Ultrasound,The First Affiliated Hospital of Shenzhen University,Shenzhen Second People's Hospital,Shenzhen,Guangdong 518035,China;Shenzhen Institutes of Advanced Technology,Chinese Academy of Sciences,Shenzhen,Guangdong 518055,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,广东省深圳市518035 [2]中国科学院深圳先进技术研究院,广东省深圳市518055

出　　处：《中国超声医学杂志》2022年第5期481-484,共4页Chinese Journal of Ultrasound in Medicine

基　　金：深圳市第二人民医院临床研究基金广东省高水平医院建设项目(No.20213357016);广东省自然科学基金(No.2020B1515120061);深圳市三名工程项目(No.SZSM201612027);深圳市重点医学学科建设基金(No.SZXK052);深圳市科技创新委员会项目(No.2021Szvup052)。

摘　　要：目的基于颅外段椎动脉血流频谱的快速傅里叶分析(FFT)评估颅内段椎动脉(IVA)轻中度(<70%)狭窄性病变。方法收集93例经颈动脉超声及CTA检查的患者资料,CTA诊断为单侧颅内段椎动脉轻中度狭窄患者62例,共62条椎动脉纳入狭窄组,超声和CTA检查均诊断为椎动脉正常者31例,共62条正常椎动脉纳入正常组,共纳入124条椎动脉进行分析。提取两组患者的颅外段椎动脉血流频谱的等间距散点数据进行FFT分析,将振幅谱中一阶至二十阶谐波的振幅之和与零频振幅的比值定义为零频比(ZFR),同时测量常规超声血流参数包括收缩期峰值流速(PSV)、舒张末期流速(EDV)和阻力指数(RI),分析两组间零频比(ZFR)与常规血流参数(PSV、EDV和RI)评估颅内段椎动脉轻中度狭窄的诊断效能。结果两组间PSV无统计学意义,狭窄组RI和ZFR高于正常组,EDV低于正常组。ZFR与颅内段椎动脉轻中度狭窄有良好的相关性,相关系数为0.565(P<0.001)。ZFR、PSV、EDV和RI的曲线下面积(AUC)分别为0.826、0.518、0.768和0.806,ZFR提示IVA狭窄的诊断效能优于常规参数(PSV、EDV和RI),其最佳截断值为ZFR>1.24,灵敏度和特异度分别为74.2%和82.3%。结论FFT能有效分析颅外段椎动脉频谱,ZFR>1.24可提示颅内段椎动脉轻中度狭窄,有望成为超声提示IVA狭窄的一项辅助指标。Objective The study aimed to evaluate mild to moderate(<70%)intracranial vertebral arterial(IVA)stenosis by Fast-Fourier transform(FFT)based on extracranial vertebral arterial doppler waveform.Methods The research enrolled 93 patients whom underwent with carotid artery ultrasound and CTA examination.62 patients(62 vertebral arteries)with unilateral IVA mild to moderate stenosis diagnosed by CTA were included in the stenosis group,and 31 patients(62 vertebral arteries)with normal vertebral arteries were included in the normal group.The equidistant scatter data of extracranial vertebral arterial doppler waveform of the two groups were extracted and analyzed by FFT.The ratio of the sum of amplitudes of from the first to twentieth order harmonics to the amplitude of zero frequency was defined as zero frequency ratio(ZFR).Besides,the conventional parameters were measured,including peak systolic velocity(PSV),end diastolic velocity(EDV)and resistance index(RI).The diagnostic efficacy was evaluated by analyzing the ZFR and conventional parameters(PSV,EDV and RI)between the two groups.Results There was no significant difference in PSV between the two groups.RI and ZFR in the stenosis group were higher than those in the normal group and EDV was decreased.ZFR had a good correlation with intracranial vertebral artery stenosis,with the correlation coefficients of 0.565(P<0.001).The area under the curve(AUC)of ZFR,PSV,EDV and RI were 0.826,0.518,0.768 and 0.806 respectively.ZFR showed higher diagnostic efficiency for IVA stenosis than conventional parameters(PSV,EDV and RI).The optimal cut-off value was ZFR>1.24,and the sensitivity and specificity were 74.2%and 82.3%respectively.Conclusions FFT can effectively analyze the extracranial vertebral arterial doppler waveform.ZFR>1.24 can indicate intracranial vertebral arterial stenosis,which is expected to become an auxiliary indicator of IVA stenosis.

关 键 词：颅内动脉狭窄 血流动力学 快速傅里叶变换 椎动脉 

分 类 号：R743.3[医药卫生—神经病学与精神病学]