经颅多普勒超声联合C形臂CT在急性缺血性脑血管介入治疗前的临床预判价值  

Value of transcranial Doppler ultrasound combined with C-shaped arm CT in the clinical prediction of acute ischemic cerebrovascular disease

作　　者：孙晓鑫 陈静霞 杜文雯 李光雷 郭乃娇 SUN Xiaoxin;CHEN Jingxia;Du Wenwen;LI Guanglei;GUO Naijiao(the Third Hospital of Peking University Qinhuangdao Hospital,Qinhuangdao,Hebei,066000)

机构地区：[1]北京大学第三医院秦皇岛医院,河北秦皇岛066000

出　　处：《实用临床医药杂志》2023年第21期135-138,共4页Journal of Clinical Medicine in Practice

基　　金：河北省秦皇岛市科学技术研究与发展计划项目(202005A037)。

摘　　要：目的探讨经颅多普勒超声(TCD)联合C形臂CT技术在急性缺血性脑血管(ICVD)介入治疗前预判的临床价值。方法选取收治的急性ICVD患者57例为研究对象。所有患者行介入治疗时,利用C形臂CT技术、TCD获取图像,并详细记录检查结果。以数字减影血管造影(DSA)检查结果为“金标准”,评估TCD联合C形臂CT技术在急性ICVD介入治疗前的临床评估价值。结果采用DSA检测57例急性ICVD患者颅内外血管共613条。DSA检测显示,颅内外狭窄或者闭塞血管153(24.96%)条,正常颅内外血管460(75.04%)条;与DSA金标准相比,C形臂CT技术的阳性预测率为91.16%(134/147),TCD检测的阳性预测率为90.60%(135/149),TCD联合C形臂CT技术检测阳性预测率为90.42%(151/167)。C形臂CT技术、TCD检测、TCD联合C形臂CT技术检测阳性预测值、特异度、准确度比较,差异无统计学意义(P>0.05);C形臂CT技术、TCD检测阴性预测值、灵敏度比较,差异无统计学意义(P>0.05);TCD联合C形臂CT技术检测阴性预测值、灵敏度高于C形臂CT技术、TCD检测,差异有统计学意义(P<0.05)。结论TCD联合C形臂CT技术在急性ICVD患者介入治疗前预判的临床价值较高,可有效降低漏诊率,具有较高的诊断效能。Objective To explore the clinical value of transcranial Doppler examination(TCD)combined with Cshaped arm CT technique for prediction of acute ischemic cerebrovascular disease(ICVD)before intervention.Methods Fifty-seven patients with acute ICVD were selected as the study objects.When all patients underwent interventional therapy,C-shaped arm CT technology and TCD were used to obtain images,and the examination results were recorded in detail.Digital subtraction angiography(DSA)was used as the"gold standard"to evaluate the clinical value of TCD combined with C-shaped arm CT before acute ICVD interventional therapy.Results A total of 613 intracranial and extracranial vessels were detected by DSA in 57 patients with acute ICVD.DSA showed that there were 153(24.96%)intracranial and extracranial stenosis or occlusion vessels and 460(75.04%)normal extracranial vessels;compared with DSA gold standard,the positive prediction rate of C-shaped arm CT was 91.16%(134/147),that of TCD was 90.60%(135/149),and that of TCD combined with C-shaped arm CT was 90.42%(151/167).There were no significant differences in positive predictive value,specificity and accuracy between C-shaped arm CT,TCD and TCD combined with C-shaped arm CT(P>0.05);there was no significant difference in the negative predictive value and sensitivity of C-shaped arm CT and TCD(P>0.05);the negative predictive value and sensitivity of TCD combined with C-shaped arm CT were significantly higher than those of the C-shaped arm CT and TCD(P<0.05).Conclusion TCD combined with C-shaped arm CT technology has high clinical value in predicting acute ICVD patients before interventional therapy,and can effectively reduce the rate of missed diagnosis and has high diagnostic efficiency.

关 键 词：经颅多普勒超声 C形臂CT技术 急性缺血性脑血管动脉病 介入治疗 预判价值 

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]