彩色多普勒超声及血管造影对颈动脉狭窄或闭塞患者的诊断价值

目的比较彩色多普勒超声（CDFI）与数字减影血管造影（DSA）诊断颈动脉狭窄或闭塞价值，分析两者诊断结果不一致的原因。 方法回顾性分析2010年8月至2014年7月在山东省聊城市第二人民医院血管超声科首次经CDFI诊断为颈动脉狭窄或闭塞，并同期行DSA检查的215例患者临床资料，Kappa检验CDFI与DSA诊断结果的一致性，对诊断结果不一致患者，复查CDFI及回顾DSA动态图像阅片，分析两者诊断结果不一致的原因。 结果首次CDFI检查与DSA检查检查结果符合率达90.7%（195/215）；两种检查方法结果一致性好（Kappa=0.7731，P<0.01）。两者诊断不一致患者经复查CDFI及回顾DSA动态图像阅片发现，其中4.7%（10例）因治疗后病情变化所致不符，1.4%（3例）因两项检查成像原理不同，3.2%（7例）因两项检查医师诊断结果不符。 结论CDFI检查颅外段颈动脉狭窄或闭塞与DSA检查结果一致性好，对部分诊断结果不一致患者应综合分析，提高诊断准确性，两项检查结果具有互补性。

Comparative study on diagnostic comparative study on diagnostic accuracy by color doppler flow imaging and angiography

ObjectiveTo evaluate the consistency of color Doppler ultrasonography (CDFI) and digital subtraction angiography (DSA) in diagnosis of carotid artery stenosis or occlusion. MethodsThe agreement and disagreement between CDFI and DSA examination results in 215 cases with unilateral carotid artery stenosis or occlusion were studied. By reviewing the CDFI sonogram and DSA dynamic image, the reason of discrepancy between two imaging modalities was analyzed. ResultsThe agreement rate was 90.7% (195 cases) between first CDFI scan and DSA, while disagreement rate was 9.3% (20 cases). Thus CDFI and DSA showed a good consistency (Kappa=0.7731, P<0.01). After reviewing the CDFI sonogram and DSA dynamic image, the discrepancy was attributed to treatment response in10 cases (4.7%), imaging principle difference in 3 cases (1.4%) , and inconsistent physician diagnoses in 7 cases (3.2%). ConclusionIn diagnosis of extracranial carotid artery stenosis or occlusion, the results of CDFI and DSA were highly consistent . In inconsistent cases, the examination results should be viewed under comprehensive and complementary analysis.