彩色多普勒超声和数字减影血管造影检测颅外颈动脉狭窄的临床对比研究

目的 评价血管超声检查在颅外颈动脉粥样硬化斑块并狭窄检测中与全脑数字减影血管造影（digital subtraction angiography,DSA）检查的一致性.方法 对80例脑梗死或者有慢性脑供血不足包括短暂性脑缺血发作和高度怀疑有血管狭窄的患者颈部105条动脉颅外段同时进行血管超声及DSA检查,以DSA检查结果为金标准,分析血管超声检查对血管狭窄程度为轻度、中度、重度及闭塞的颈部动脉病变检出的敏感性、特异性及准确性.并分别对超声强回声组和非强回声组,有症状组和无症状组的敏感性、特异性及准确性进行比较.结果 血管超声检查对血管狭窄程度为轻、中度、重度及闭塞的颈部动脉病变检出的敏感性分别79.4％、47.2％、57.1％、92.9％,特异性分别为71.8％、85.5％、94.0％、98.9％,准确性分别为73％、72.4％、86.7％、98.1％.强回声组血管超声的一致性较非强回声组的好,症状性动脉狭窄组血管超声的一致性较无症状性动脉狭窄组好,差异有统计学意义（P＜0.05）.结论 血管超声技术对颈部动脉病变,特别是在严重狭窄或闭塞性病变的检测中有较高的准确性,可以应用于临床上动脉狭窄的筛查.

Comparison between color Doppler ultrasound and digital subtraction angiography in detecting extracranial carotid artery stenosis

Objectives To evaluate the consistency of color Doppler ultrasound （US） and digital subtraction angiography （DSA） in the measurement of extracranial carotid artery stenosis.Methods Totally 80 patients with cerebral infarction,transient ischemic attack and highly suspected artery stenosis including 105 extracranial carotid artery underwent US and DSA.According to the golden standard of DSA result,the sensitivity,specificity and accuracy of US result of artery stenosis were analysed.High-density echo and non-high-density echo groups,symptomatic and asymptomatic extracranial carotid artery were compared respectively.Results The sensitivity of US in the measurement of slight,midrange,severe and occluded extracranial carotid artery stenosis were 79.4%,47.2%,57.1%,92.9%; the specificity were 71.8%,85.5%,94.0%,98.9% and the accuracy were73%,72.4%,86.7%,98.1%.The consistency in high-density echo group was better than that of non-high-density echo group （P〈0.05）.The consistency in symptomatic extracranial carotid artery group was better than that of asymptomatic extracranial carotid artery group （P〈0.05）.Conclusions The accuracy of US detecting extracranial carotid artery was high.US should be suggested to be the preliminary screening examination for extracranial carotid artery.