血管扫描用于诊断周围血管疾病的临床研究

对１７６名患者的７５７个动脉段分别做了快速血管扫描（ｑｕｉｃｋｓｃａｎ，ＱＳ）及血管造影两项检查。以ＱＳ系统血管相邻两点多普勒频移的比率≥１：３作为判断血管存在临界狭窄（血管直径减少５０％以上）的阈值。结果：与血管造影结果相比，ＱＳ诊断血管临界狭窄的敏感性、特异性和准确性分别为８８％、９４％和９２％；诊断血管闭塞的敏感性、特异性和准确性分别为９１％、９５％和９４％；ＱＳ发现血管的狭窄程度与踝肱指数呈明显负相关（ｒ＝０．７７，Ｐ＜０．０１）。本组中３７名患者根据ＱＳ检查结果进行了经皮穿刺血管成型术，术中证实病变的存在，效果令人满意。由此表明，在周围血管疾病的诊断中，ＱＳ可以作为迅速准确、无创伤、费用低廉的常规检查手段，适合在我国推广应用。

CLINICAL STUDY OF QUICKSCAN IN DIAGNOSIS OF PERIPHERAL VASCULAR DISEASE(A REPORT OF 176 CASES)

The ability of quickscan(QS)to assess haemodynamically significant lesions in the iliac and femoro-popliteal arteries was studied. Quickscan was prospectively and independently compared to intra-arterial digital subtraction angiography(IADSA) of the if iliac and femoro-popliteal arteries. In 176 patients 757 arterial segments were evaluated. A QS frequency ratio of 1: 3 or greater had a sensitivity of 88%,a specificity of 94% and accuracy of 92% in detecting stenosis>50% diameter (67% area)reduction as shown on IADSA. In the detection of occlusion,QS had a sensitivity of 91%,specificity of 95% and accuracy of 94%. There was significant correlation between area reduction found by QS and the calf/brachial pressure index(CBI) (r=-0. 77,P<0. 01 ). Thirty-seven patients underwent an angioplasty based on QS finding alone. All 37 were successful. The authors conclude that quickscan can provide an inexpensive,quick and non-invasive screening technique for the routine initial assessment of peripheral vascular disease. The results indicate that an agreement with angiography which is as good as duplex scanning. It has potential to replace angiography for workup prior to surgical or catheter intervention,in the assessment of the success of the procedure and its continuing follow-up.