颈脑血管一体化超声评估在缺血性脑卒中患者中的诊断价值  

The diagnostic value of integrated assessment of cervical and cerebrovascular ultrasound in patients with ischemic brain stroke

作　　者：郭曼 刘犇[1] 吴桐[1] 张子青[1] 张晗 GUO Man;LIU Ben;WU Tong;ZHANG Ziqing;ZHANG Han(Department of Physical Diagnosis,the Affiliated Brain Hospitial of Nanjing Medical University,Nanjing,Jiangsu 210000,China)

机构地区：[1]南京医科大学附属脑科医院物理诊断科,江苏南京210000

出　　处：《影像研究与医学应用》2023年第24期28-31,共4页Journal of Imaging Research and Medical Applications

摘　　要：目的:探讨颈脑血管一体化超声评估在缺血性脑卒中患者中的诊断价值。方法:收集2020年12月—2023年6月期间南京医科大学附属脑科医院收治的108例缺血性脑卒中患者资料,所有患者均接受颈脑一体化超声检查和数字减影血管造影(DSA)检查,以DSA为“金标准”,对颈脑一体化超声检查结果进行分析。结果:108例患者中,颈脑血管一体化超声检出血管病变92例,DSA检出血管病变99例,检出率分别为85.2%和91.7%,颈脑一体超声检出率略低于DSA,但差异无统计学意义(P> 0.05)。进一步计算颈脑血管一体化超声狭窄程度诊断准确率为79.6%,灵敏度90.9%,特异度77.8%,约登指数0.69,阳性预测值97.8%,阴性预测值43.8%,与金标准一致性较好,Kappa值=0.705(P <0.05)。结论:颈脑血管一体化超声评估与DSA检查结果比较一致性较好,可作为首选筛查手段,为缺血性脑卒患者的早期筛查和临床诊疗提供可靠信息。Objective To evaluate the diagnostic value of integrated assessment of cervical and cerebrovascular ultrasound in patients with ischemic stroke.Methods 108 patients with ischemic stroke admitted to the Affiliated Brain Hospital of Nanjing Medical University from December 2020 to June 2023 were collected.All patients underwent cervical and cerebrovascular ultrasonography and digital subtraction angiography(DSA).The results of cervical and cerebrovascular ultrasonography were analyzed with DSA as the"gold standard".Results Among the 108 patients,92 cases were detected by cervical and cerebrovascular ultrasound,and 99 cases were detected by DSA,the detection rate was 85.2%and 91.7%,respectively.The detection rate of cervical and cerebrovascular ultrasound was slightly lower than that of DSA,and the difference was not statistically significant(P>0.05).The diagnostic coincidence rate of stenosis degree was 79.6%,the sensitivity was 90.9%,the specificity was 77.8%,the Youden index was 0.69,the positive predictive value was 97.8%,the negative predictive value was 43.8%,the consistency with the gold standard was well,Kappa value=0.705(P<0.05).Conclusion The results of cervical and cerebrovascular ultrasound integration evaluation are in good agreement with DSA examination,and can be used as the first choice screening method to provide reliable information for early screening and clinical diagnosis of patients with ischemic brain stroke.

关 键 词：颈动脉超声 经颅彩色多普勒超声 颈动脉狭窄 脑卒中 

分 类 号：R445.1[医药卫生—影像医学与核医学]