二维灰阶血流成像对老年人颈内动脉中-重度狭窄的诊断价值评估

目的：评价二维灰阶血流成像（BFI）诊断老年人颈内动脉中-重度狭窄的临床价值。方法采用BFI和彩色多普勒超声成像（CDFI）分别测量老年人颈内动脉。观察组24例，对照组30例，以数字减影血管造影（DSA）检查结果为金标准，记录颈内动脉直径、收缩期峰值流速（PSV）、舒张末期流速（EDV）等血流动力学参数。结果（1）观察组24例患者颈内动脉BFI诊断结果为：正常6例，狭窄＜50%3例，狭窄50%~69%30例，狭窄70%~99%9例；CDFI诊断结果为正常6例，狭窄＜50%11例，狭窄50%~69%25例，狭窄70%~99%6例。（2）BFI对颈内动脉狭窄情况的诊断与DSA诊断结果一致性较高（Kappa=0.962，P＜0.01）。（3）当颈内动脉狭窄为50%~69%时，BFI对颈内动脉狭窄诊断与DSA诊断之间的相关系数高于CDFI与DSA诊断之间的相关系数（Z=2.169，P＜0.05）。结论 BFI能准确诊断颈内动脉狭窄程度，与DSA诊断之间的一致性较高，适用于对介入检查耐受性低的老年人群。

Diagnostic value on two-dimensional blood flow imaging for moderate-severe stenosis of internal carotid artery in elderly patients

Objective To evaluate the application of two- dimensional blood flow imaging （2- D BFI） in diagnosis of mod-erate- severe stenosis of internal carotid artery in elderly patients. Methods The internal carotid artery was examined by 2- D BFI and color Doppler flow imaging（CDFI） in 24 elderly patients and 30 healthy controls. Hemodynamic parameters of internal carotid artery including diameter, peak systolic velocity （PSV）, end- diastolic velocity （EDV） were measured. With digital subtraction an-giography（DSA） as gold standard the diagnostic value of 2- D BFI and CDFI in diagnosis of internal carotid artery stenosis was e-valuated. Results BFI results showed that internal carotid arteries were normal in 6 cases, stenosis＆lt;50%in 3 cases;stenosis 50%~69% in 30 cases and stenosis 70%~99% in 9 cases. CDFI results showed that internal carotid arteries were normal in 6 cases;stenosis＆lt;50%in 11 cases;stenosis 50%~69%in 25 cases and stenosis 70%~99%in 6 cases. The results measured by BFI and DSA were highly consistent with those by DSA（Kappa=0.962, P〈0.01）. When the internal carotid artery stenosis rate was 50%~69% the correlation coefficient between BFI and DSA was higher than that between CDFI and DSA （Z=2.169, P〈0.05）. Conclusion The result of internal carotid artery stenosis measured by BFI is highly consistent with that of DSA, indicating that BFI can be used for elderly patients who are less tolerat for intervention examination.