脑卒中筛查颈部血管狭窄性病变的超声诊断与MRI血管成像的价值对比  

Comparison on the diagnostic value of ultrasound and MRI angiography for cervical vascular stenosis in stroke

作　　者：彭金花 曾莉 Peng Jin-hua;Zeng Li(Department of Ultrasound Medicine,Yudu People's Hospital,Ganzhou 341000,Jiangxi,China;Department of Imaging,Yudu People's Hospital,Ganzhou 341000,Jiangxi,China)

机构地区：[1]于都县人民医院超声医学科,江西赣州341000 [2]于都县人民医院影像科,江西赣州341000

出　　处：《四川生理科学杂志》2024年第11期2414-2416,共3页

基　　金：赣州市科技计划项目(项目编号:20222ZDX8843)。

摘　　要：目的:探讨脑卒中筛查颈部血管狭窄性病变的超声与核磁共振(Magnetic Resonance Imaging,MRI)血管成像的诊断价值。方法:选取2022年10月至2023年10月在于都县人民医院确诊的62例脑卒中患者,所有患者均接受颈部血管超声检查和MRI检测,以数字减影血管造影(Digital Subtraction Angiography,DSA)检查结果作为金标准,比较上述两种检测方法诊断及其联合诊断的准确度和kappa一致性。结果:以DSA结果为金标准,颈动脉超声诊断敏感度和特异度分别76.19%和76.92%,MRI血管成像诊断敏感度和特异度分别90.48%和73.85%,两种检查方式诊断结果kappa一致性分别为0.457和0.518,联合诊断敏感度和特异度分别95.24%和76.92%,kappa一致性分别为0.589,均具有较好一致性。颈动脉超声诊断准确度、阳性预测值、阴性预测值分别为76.74%、51.61%和90.91%,MRI结果分别为77.91%、52.78%和96.00%,联合诊断结果分别为81.40%、57.14%和98.04%(P>0.05)。62例脑卒中患者DSA检查结果显示:共有86处狭窄,其中轻度、中度、重度和闭塞分别为36例、29例、17例和4例,颈部血管超声检查和MRI血管成像检查结果中轻度、中度、重度和闭塞分别为31例、37例、15例、3例和34例、32例、16例和4例。结论:超声和MRI血管成像及其联合检测对脑卒中患者颈部血管狭窄性病变均具有较好的诊断价值。Objective:To explore the diagnostic value of ultrasound and magnetic resonance imaging(MRI)angiography for cervical vascular stenosis in stroke.Methods:A total of 62 patients with stroke confirmed in Yudu People's Hospital were enrolled between October 2022 and October 2023.All patients underwent cervical vascular ultrasound and MRI examinations.Taking results of digital subtraction angiography(DSA)as the golden standard,diagnostic accuracy and kappa consistency of the above two methods and combined detection were compared.Results:Taking DSA results as the golden standard,diagnostic sensitivity and specificity of carotid ultrasound were 76.19%and 76.92%,diagnostic sensitivity and specificity of MRI angiography were 90.48%and 73.85%,respectively.kappa consistency values of the two examination methods were 0.457 and 0.518,the diagnostic sensitivity and specificity of combined detection were 95.24%and 76.92%,and kappa consistency was 0.589,all showing good consistency.The diagnostic accuracy,positive predictive value and negative predictive value of carotid ultrasound,MRI angiography and combined detection were(76.74%,51.61%,90.91%),(77.91%,52.78%,96.00%)and(81.40%,57.14%,98.04%),the difference was not statistically significant(P>0.05).In the 62 stroke patients,DSA results showed that there were 86 stenosis sites,including 36 sites with mild stenosis,29 sites with moderate stenosis,17 sites with severe stenosis and 4 sites with occlusion.The results of cervical vascular ultrasound and MRI angiography were as follows:31 sites with mild stenosis,37 sites with moderate stenosis,15 sites with severe stenosis and 3 sites with occlusion;34 sites with mild stenosis,32 sites with moderate stenosis,16 sites with severe stenosis and 4 sites with occlusion.Conclusion:Ultrasound,MRI angiography and combined detection all have good diagnostic value for cervical vascular stenosis in stroke patients.

关 键 词：脑卒中 颈部血管狭窄性病变 超声 MRI血管成像 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]