TCD对缺血性脑血管病颅内动脉狭窄的诊断价值

目的：观察经颅多普勒超声（TCD）对颅内血管狭窄诊断的可靠性。方法：对确诊的128例缺血性脑血管病进行TCD与数字减影血管造影（DSA）检查，观察颅内血管的变化情况。结果：128例中共检查血管1112条，TCD发现狭窄血管183条，其中135条与DSA诊断一致，但在TCD检查正常的血管中DSA发现血管狭窄29条，显示TCD诊断血管狭窄的敏感性82．3％，特异性94．9％，阳性预测值73．7％，阴性预测值96．8％，其中对大脑中动脉的价值最大，其后依次为椎动脉、大脑前后动脉。结论：TCD对诊断脑内动脉狭窄具有较高的敏感性和特异性，尤其对大脑中动脉和椎动脉，对大脑前动脉和大脑后动脉诊断须慎重。

Diagnostic Value of Transcranial Doppler for Intracranial Artery Stenosis in Ischemic Cerebrovascular Disease

Objective: To observe the value of transcranial Doppler (TCD) in the diagnosis of intracranial artery stenosis in ischemic cerebrovascular disease. Methods: TCD and digital subtraction angiography (DSA) were performed in 128 inpatients with ischemic cerebrovascular disease. The changes of intracranial artery stenosis were observed. Results: 1112 cerebral vessels were tested in these 128 patients. Among the 183 vessels with intracranial artery stenosis tested by TCD, the diagnoses of 135 vessels were the same as those by DSA. Twenty-nine intracranial arteries showed stenosis by DSA, which were normal by TCD. The sensitivity, specificity, positive predictive value and negative predictive value of TCD were 82.3%, 94.9%, 73.7 %, and 96.8% respectively. TCD had the higher sensitivity and specificity for diagnosis of MCA and VA stenosis, but it had the lower sensitivity in ACA and PCA stenosis. Conclusion: TCD had a higher sensitivity and specificity for diagnosis of intracranial artery stenosis, and it was more accuracy for diagnosis of MCA and VA stenosis than that of ACA and PCA.