微血流成像技术在椎动脉夹层诊断中的应用价值  

Application Value of Ultra-micro Flow Imaging in the Diagnosis of Vertebral Artery Dissection

作　　者：王琰娟[1] 焦华杰 韩涛 王福霞[1] 马丽园[1] 彭晖晖 刘金芳[3] Wang Yanjuan;Jiao Huajie;Han Tao;Wang Fuxia;Ma Liyuan;Peng Huihui;Liu Jinfang(Department of Ultrasound,General Hospital of Ningxia Medical University,Yinchuan 750001,China;Department of Medical Imaging,Ningxia People’s Hospital,Yinchuan 750001,China;Department of Neurology,General Hospital of Ningxia Medical University,Yinchuan 750001,China)

机构地区：[1]宁夏医科大学总医院超声科,银川市750001 [2]宁夏人民医院医学影像科,银川市750001 [3]宁夏医科大学总医院神经内科,银川市750001

出　　处：《中国超声医学杂志》2023年第5期568-572,共5页Chinese Journal of Ultrasound in Medicine

基　　金：宁夏医科大学校级项目(No.XM2021070)。

摘　　要：目的 探讨微血流成像技术(SMI)对椎动脉夹层(VAD)的诊断效果。方法 回顾性分析20例VAD患者的临床资料,患者均接受常规超声检查、彩色多普勒超声(CDFI)、SMI检查和数字血管减影造影术(DSA)或者磁共振血管成像(MRA)或者计算机断层血管造影(CTA),对比常规超声、SMI、MRA/CTA/DSA的影像表现。结果 与健侧相比,患侧的真腔管径更小,原始管径更大,收缩期峰值流速(PSV)、阻力指数(RI)及舒张期流速(EDV)值更高(P<0.05)。常规超声对VAD的检出率为50.00%(V1段3例,V2段7例,V3段5例),SMI对VAD的检出率为90.00%(V1段6例,V2段12例,V3段13例)。SMI对VAD的检出率显著高于常规超声(P<0.05),SMI与CTA/MRA/DSA对VAD的检出率接近(P>0.05)。常规超声与MRA/CTA/DSA检出VAD的一致程度不够理想(Kappa=0.368);SMI与MRA/CTA/DSA检出VAD具有较强的一致性(Kappa=0.782)。常规超声与MRA/CTA/DSA检出壁内血肿型VAD的一致程度不够理想(Kappa=0.237),SMI与MRA/CTA/DSA检出壁内血肿型VAD具有较强的一致性(Kappa=0.736)。受试者工作特征(ROC)曲线显示SMI诊断VAD的曲线下面积(AUC)明显高于常规超声(P<0.05)。结论 SMI对VAD有较高的灵敏度与诊断符合率,可作为早期筛查VAD的理想手段。Objective To investigate the diagnostic effect of ultra-micro flow imaging(SMI)in vertebral artery dissection(VAD).Methods The clinical data of 20patients with VAD admitted to general hospital of ningxia medical university were retrospectively collected and analyzed.All patients received conventional ultrasound,SMI and digital subtraction angiography(DSA)examinations.The imaging manifestations of conventional ultrasound,SMI and DSA were analyzed.The consistency of VAD detected by conventional ultrasound and MRA/CTA/DSA was assessed.Results Compared with the unaffected side,the true lumen diameter of the affected side was smaller,the original lumen diameter was larger,and the PSV,RI and EDV values are higher(P<0.05).The detection rate of VAD by conventional ultrasound was 50.00%(3in V1,7 in V2,and 5in V3),and the detection rate of VAD by SMI was 90.00%(6in V1,12in V2,and 13in V3).The detection rate of VAD by SMI was significantly higher than that by the conventional ultrasound(P<0.05),and the detection rate of VAD by SMI and CTA/MRA/DSA was similar(P>0.05).The consistency of VAD detected by conventional ultrasound and MRA/CTA/DSA was not ideal(Kappa=0.368);There was a strong consistency between VAD detected by SMI and MRA/CTA/DSA(Kappa=0.782).The consistency between conventional ultrasound and MRA/CTA/DSA in detecting intramural hematoma type VAD was also unsatisfactory(Kappa=0.237),while the consistency between SMI and MRA/CTA/DSA in detecting intramural hematoma type VAD was strong(Kappa=0.736).Receiver operating characteristic curve showed that the area under the curve value of VAD diagnosed by SMI was significantly higher than that of the conventional ultrasound(P<0.05).Conclusions SMI has a high sensitivity and diagnostic accurate rate for VAD,and can be used as an ideal method for early screening of VAD.

关 键 词：椎动脉夹层 微血流成像 常规超声 诊断价值 

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]