彩超与血管造影对颅外段颈内动脉狭窄诊断的相关性比较

目的比较彩色多普勒超声（DUS）、数字减影血管造影（DSA）两种方法对颅外段颈内动脉粥样硬化后狭窄检出率的敏感性、特异性、准确性及DUS与DSA对该部位动脉狭窄诊断的相关性。方法对105例大脑缺血性患者行DUS、DSA检查，依据北美症状性颈动脉内膜切除试验法，将颅外段颈内动脉狭窄分为4级，轻度（〈50％），中度（51％-69％），重度（70％-99％），闭塞（100％）。结果1例在DSA后出现脑梗死症状，105例210条颅外段颈内动脉DUS与DSA诊断相符合血管177条（84．3％），DUS对正常颅外段颈内动脉诊断的敏感性、特异性、准确性分别为93．3％、86．8％、90．O％；对轻度狭窄血管分别为60．O％、95．0％、91．4％；对中度狭窄血管分别为71．0％、97．9％、94．3％；对重度狭窄血管分别为81．8％、96．4％、93．3％；对闭塞血管为90．9％、100％、99．5％。结论DUS对评价颅外段颈内动脉粥样硬化性狭窄与DSA一致性较好，但对轻度及中度狭窄的漏诊率较高，必要时尚需行DSA检查。

Comparation on the relevance of color Doppler ultrasound and digital subtraction angiography in the diagnosis of extracranial internal carotid artery stenosis

Objective To compare the sensitivity, specificity, accuracy of color Doppler ultra- sound （DUS） and digital subtraction angiography （DSA） in detection rate of extracranial internal carotid artery atherosclerotic stenosis, and the relevance of the two methods in the diagnosis of stenosis. Methods DUS and DSA were performed on 105 cases of ischemic patients. Accord- ing to North American Symptomatic Carotid Endarterectomy Trial, extracranial internal carotid artery stenosis was classified into four grades： mild （the diameter reduction 〈50%）, moderate （51%69%）, severe （70%%99%）, and total occlusion. Results One patient suffered from acute brain infarction after DSA, and the consistency of extracranial internal carotid artery stenosis diagnosed by DUS and DSA was 177 （84.3%） in 210 of 105 cases. The sensitivity; specificity and accuracy of DUS to normal extracranial carotid artery were 93.3%, 86.8% and 90.0%; to mild extracranial carotid artery stenosis were 60.0%, 95.0% and 91.4%; to moderate extracra- nial carotid artery stenosis were 71.0%, 97.9% and 94.3%; to severe extracranial carotid artery stenosis were 81.8%, 96.4% and 93.3%; and to ext.racranial carotid artery occlusion were 90.9%, 100% and 99.5%. Conclusion There is good relevane between DUS and DSA in the diagnosis of extracranial carotid artery stenosis, the rate of missed diagnosis of mild and moderate stenosis is high. It is necessary to perform DSA at this situation.