彩色多普勒超声在颈动脉狭窄诊断中的应用价值

王丽萍

（西京医院正和住院部，陕西 西安，710054）

浏览次数：108次 下载次数：338次

摘要：

目的 研究彩色多普勒超声（CDFI）在颈动脉狭窄诊断中的应用价值。方法 选取我院收治的80例疑似颈动脉狭窄患者作为研究对象，所有患者均行CDFI和数字减影血管造影（DSA）检查，统计CDFI诊断的灵敏度、特异度、准确性、阳性预测值、阴性预测值，并根据DSA检查结果将研究对象分成狭窄组和无狭窄组，比较两组的血流学指标，采用Kappa 一致性检验 CDFI与DSA的一致性。结果 CDFI诊断的灵敏度为87.84%，特异度为66.67%，准确性为86.25%，阳性预测值为97.01%，阴性预测值为30.77%。狭窄组PSV和EDV 等CDFI指标均显著低于无狭窄组（P<0.05）。Kappa 一致性检验发现，CDFI与DSA检查结果的一致性较高（Kappa 值=0.650，P<0.01）。结论 颈动脉狭窄患者多存在血流速度减缓情况，CDFI能准确反映颈动脉狭窄程度，诊断准确性较高，但不能完全替代DSA。

关键词：CDFI；DSA；颈动脉狭窄；诊断

中图分类号：R445.1；R543.4文献标志码：A文章编号：2096-1413(2017)18-0140-02

Application value of color Doppler ultrasound in the diagnosis of carotid artery stenosis
WANG Li-ping
(Zhenghe Inpatient Department of Xijing Hospital, Xi``an 710054, China)

ABSTRACT: Objective To study the application value of color Dopp ler ultrasound in the diagnosis of carotid artery stenosis. Methods Eighty patients with suspected carotid stenosis in our hospital were selected as the study objects, all the patients underwent CDFI and digital subtraction angiography (DSA). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of CDFI in the diagnosis of carotid artery stenosis were calculated accorded. The patients were divided into stenosis group and non stenosis group according to the DSA results, and the hemoreology indicators were compared in the two groups. The consistency of CDFI with DSA in diagnosis of carotid artery stenosis was tested by Kappa consistency. Results The sensitivity of CDFI was 87.84%, the specificity was 66.67%,the accuracy was 86.25%, the positive predictive value was 97.01%, the negative predictive value was 30.77%. The PSV and EDV of CDFI index in the stenosis group were significantly lower than those in non stenosis group (P<0.05). The Kappa consistency test showed that CDFI and DSA were highly consistent (Kappa=0.650, P<0.01). Conclusion Most patients with carotid stenosis has slow blood flow characteristics, the CDFI can accurately reflect the degree of carotid stenosis. The accuracy of screening carotid artery stenosis is high, but it can``t completely replace DSA.
KEYWORDS: CDFI; DSA; carotid artery stenosis; diagnosis

参考文献：
[1] 方传勤,吴小三.症状性颈动脉狭窄对急性脑梗死患者短期预后的影响[J].中华老年心脑血管病杂志,2014,16(3):233-236.
[2] 谭瑶.彩色多普勒超声与DSA诊断缺血性脑血管病患者颅外段颈动脉狭窄的对照研究[J].河北医学,2016,22(5):708-711.
[3] 孟云,周宏斌,尚芙蓉.经颅多普勒超声与数字减影血管造影诊断颈动脉狭窄的对比[J].中国老年学杂志,2016,36(24):6129-6131.
[4] 张祖建,张勇,陈淑君,等.MSCTA、2DDSA 和3DDSA对颈动脉狭窄测量差异比较的实验研究[J].重庆医学,2015,44(3):359-361,365.
[5] 刘亚,刘娅妮,邓又斌.超声造影在动脉粥样硬化病变中的应用[J]. 中华超声影像学杂志,2014,23(1):76-78.
[6] 陈新燕,温昌明,朱相宙.颈动脉超声筛查在颈动脉狭窄与脑卒中 高危人群中的应用价值探讨[J].重庆医学,2015,44(24):3426-3428.
[7] 张善春,迟路湘.血管超声与脑血管造影诊断颈动脉狭窄的对比研 究[J].中华老年心脑血管病杂志,2012,14(4):408-410.
[8] SAVVA E,SZTAJZEL R,LANDIS T,et al.Reversed flow in the external carotid artery despite a patent but stenosed common carotid artery[J]. J Neuroimaging,2010,20(2):187-188.
[9] 张耀楠,李艳,康雁.基于CT 影像的颈动脉分叉血流动力学特性分析[J].东北大学学报:自然科学版,2014,35(3):356-360.
[10] 华扬,刘蓓蓓,凌晨,等.超声检查对颈动脉狭窄50%～69%和70%～99%诊断准确性的评估[J].中国脑血管病杂志,2006,3(5):211-218.
[11] 袁嘉,勇强,张蕾,等.常规血管超声与微血管成像技术诊断颈动脉狭窄的对比研究[J].中国循环杂志,2016,31(6):601-603.