经颅多普勒检测颈内动脉颅外段轻度狭窄的敏感性和特异性

Sensitivity and Specificity of Transcranial Doppler to Detect Mild Stenosis of Extracranial Internal Carotid Artery

目的 探讨经颅多普勒检测颈内动脉颅外段轻度狭窄的敏感性和特异性。方法 采用经颅多普勒超声检测 110例颈内动脉颅外段轻度狭窄 (<5 0 % )患者颈内动脉颅外段血流速度和搏动指数。结果 经颅多普勒检测颈动脉轻度狭窄平均流速的敏感性为 88.3% ,收缩期峰流速的敏感性为 92 .6 % ,特异性为 97.3%。动脉硬化斑块的长度和厚度与血流速度相关 (r =0 .34,P <0 .0 5和r =0 .4 8,P <0 .0 1)。狭窄面积 2 1%～ 4 9%组的血流速度高于 <2 0 %组 ,但无明显差异 (P >0 .0 5 )。

Aim To explore the sensitivity and specificity of transcranial Doppler to detect mild stenosis of extracranial internal carotid artery. Methods The flow velocity and pulsatility index were measured with transcranial Doppler in 110 patients with mild stenosis (<50%) of extracranial internal carotid artery. Results Transcranial Doppler had sensitivity of 88.3% (mean flow velocity) and 92.6% (systolic peak flow velocity) with specificity of 97.3% to detect the mild stenosis of carotid artery. The length and thickness of atherosclerotic plaque were closely correlated with the flow velocities (r=0.34, P<0.05 and r=0.48,P<0.01). The flow velocity was higher in patients with 21%～49% stenotic area than those with <20% stenotic area, but statistical analysis did not discriminate (P>0.05). Conclusions Transcranial Doppler might be of some significance in determining the atherosclerotic plaque and mild stenosis of carotid artery.