颈动脉超声联合眼动脉超声对颈内动脉颅内段病变的定位诊断价值  

The value of combining carotid ultrasound with ophthalmic artery ultrasound for localizing and diagnosing lesions in the intracranial segment of the internal carotid artery

作　　者：赵彤 赵诚[1] ZHAO Tong;ZHAO Cheng(Department of Abdomen Ultrasound,The Affiliated Hospital of Qingdao University,Qingdao 266003,China;Department of Ultrasound,Linyi People’s Hospital)

机构地区：[1]青岛大学附属医院腹部超声科,青岛266003 [2]临沂市人民医院超声医学科

出　　处：《国际医学放射学杂志》2023年第6期659-665,690,共8页International Journal of Medical Radiology

摘　　要：目的探讨颈动脉多普勒超声(CDU)联合眼动脉(OA)超声评估颈内动脉(ICA)颅内段重度狭窄或闭塞位置的应用价值。方法回顾性收集经数字减影血管造影(DSA)证实为单侧ICA颅内段重度狭窄或闭塞病人(病变组)97例及ICA颅内段无明显狭窄对照者(对照组)85例,根据病变程度和位置将病变组病人进一步分为重度狭窄OA分支前组(30例)、重度狭窄OA分支后组(21例)、闭塞OA分支前组(28例)、闭塞OA分支后组(18例)。所有病人均行超声检查测量ICA颅外段及OA的血流动力学参数。采用单因素方差分析比较各组间ICA颅外段和OA的血流动力学参数的差异,进一步两两比较采用LSD-t检验;采用受试者操作特征(ROC)曲线分析ICA颅外段和OA血流动力学参数对ICA颅内段病变位置的诊断效能。结果重度狭窄病人和闭塞病人的OA分支前组、OA分支后组的患侧ICA颅外段收缩期峰值流速(PSV)、舒张末期流速(EDV)均低于对照组,阻力指数(RI)高于对照组,OA分支前组的患侧EDV高于OA分支后组及对照组,搏动指数(PI)低于OA分支后组及对照组(均P<0.05)。ROC曲线分析显示,重度狭窄病人双侧OA的PI变异度、闭塞病人患侧ICA颅外段RI和双侧OA的PI变异度对于判定ICA颅内段病变位置具有较好的诊断效能。结论联合分析ICA颅外段和OA血流动力学参数,可以有效确定ICA颅内段重度狭窄或闭塞的病变位置。Objective To investigate the application value of carotid doppler ultrasound(CDU)combined with ophthalmic artery(OA)ultrasound for assessing the location of severe stenosis or occlusive lesions in the intracranial internal carotid artery(ICA).Methods We retrospectively studied 97 patients with severe stenosis or occlusive lesions in the unilateral intracranial ICA diagnosed by DSA(study group)and 85 patients without severe stenosis or occlusive lesions(control group).Based on the degree and location of the lesions,there were 30 patients in the severe stenosis pre-OA group,21 patients in the severe stenosis post-OA group,28 patients in the occlusive lesions pre-OA group,and 18 patients in the occlusive lesions post-OA group.Hemodynamic parameters of intracranial ICA and OA were obtained from all patients using CDU combined with OA ultrasound.One-way analysis of variance(ANOVA)was performed to compare extracranial ICA and OA hemodynamic parameters among all the groups,and the LSD-t was employed for post-hoc comparisons.Receiver operating characteristic(ROC)curves were used to analyze the diagnostic efficiency of extracranial ICA and OA hemodynamic parameters in different locations of severe stenosis or occlusive lesions in the intracranial ICA.Results Compared to the control group,the affected-side extracranial ICA peak systolic velocity(PSV)and end diastolic velocity(EDV)decreased,while resistance index(RI)increased in the pre-OA and post-OA groups of severe stenosis and occlusive lesions patient.Compared to the control group and post-OA group,the affected-side OA pulsatility index(PI)decreased,and EDV increased in the pre-OA group(all P<0.05).According to ROC analysis,PI variability of bilateral OA in the severe stenosis patients,RI of the affected-side extracranial segment of ICA,and PI variability of bilateral OA in the occlusion patients showed good diagnostic efficacy for differentiating the location of lesions in the intracranial ICA.Conclusion The location of severe stenosis or occlusive lesions in the intr

关 键 词：超声检查 颈内动脉 颅内段 血流动力学 眼动脉 

分 类 号：R445.1[医药卫生—影像医学与核医学] R543.5[医药卫生—诊断学]