彩色多普勒超声和数字减影血管造影检测锁骨下动脉狭窄的临床对比研究

目的探讨彩色多普勒超声(CDS)与数字减影血管造影(DSA)检测锁骨下动脉狭窄的临床价值。方法选择锁骨下动脉狭窄患者62例,均行CDS和DSA检查,CDS包括彩色多普勒血流现象(CDFI),频谱多普勒(SD),CDFI联合SD等3种方法,其与DSA的一致性比较用Kappa检验;CDS的诊断性检验用ROC曲线下面积(AUC)分析。结果DSA检出血管狭窄Ⅰ级患者17例,Ⅱ级25例,Ⅲ级20例。与DSA一致性比较,CDFI一致性差,SD一致性较好,CDFI联合SD一致性很好。与CDFI或SD单项检查比较,CDFI联合SD检查,AUC明显增高(血管狭窄Ⅰ级与Ⅱ级比较,AUC=0.934:血管狭窄Ⅱ级与Ⅲ级比较,AUC=0.91 7),诊断准确度高。结论CDFI联合SD检测锁骨下动脉狭窄具备一定优势,可作为检测此类疾病的初次筛查方法。

Comparison between CDS and DSA in detecting subclavian artery stenosis

Objective To investigate the value of color Doppler sonography(CDS) and digital subtraction angiography(DSA) in detection of subclavian artery stenosis.Methods Sixty-two patients with subclavian artery stenosis were selected.They all underwent CDS and DSA.When patients underwent CDS,three detecting methods(color Doppler flow image(CDFI),spectra Doppler (SD),CDFI combined with SD) were used.Correlation analysis between these detecting methods used the kappa statistics.CDS diagnosis test used the area under ROC curve(AUC).Results Sixty -two subclavian artery stenoses were detected by DSA(mild 17,moderate 25,severe 20).DSA was in poor agreement with CDFI,good agreement with SD,and excellent agreement with CDFI combined with SD.Compared with CDFI or SD,when CDFI combined with SD,the AUC became higher(mild stenosis compared with moderate stenosis,AUC=0.934;moderate stenosis compared with severe stenosis,AUC=0.917) and diagnosis accuracy was improved,with statistically significant difference.Conclusion Compared with DSA,CDFI combined with SD can detect the subclavian artery stenosis more effectively,it can be used for the preliminary screening in detection of subclavian artery stenosis.