不同多普勒血流参数分级标准检测颈内动脉狭窄程度的准确性

The accuracy of different standards of Doppler velocity parameters for grading internal carotid stenosis

目的探讨不同多普勒血流参数分级标准诊断颈内动脉狭窄程度的准确性。方法对91例患者的182支血管行颈动脉超声及血管造影检查,分别采用Strandness、Washington、Faught、 Bluth、Caroll和我院的多普勒血流参数标准对颈内动脉狭窄程度行分级诊断,并与血管造影的欧洲颈动脉外科试验法(ECST)的测量结果比较,计算不同多普勒狭窄分级指标诊断的敏感性(SEN)、特异性(SPE)、阳性预测值(PPV)、阴性预测值(NPV)及Kappa值。结果我院多普勒血流参数分级标准的SEN、SPE、PPV、NPV及Kappa值明显高于其他分级标准。结论不同研究机构应当建立适合自身临床应用的评价颈动脉狭窄程度多普勒血流参数的分级指标。目前,我院超声检测颈内动脉狭窄程度的血流动力学参数诊断标准的准确性较高,得到临床肯定。

Objective To evaluate the accuracy of different standards of Doppler velocity parameters used to grade internal carotid stenosis. Methods The 182 carotid arteries of 91 cases who had internal carotid lesions were examined by ultrasound and angiogragpy using the standards of Doppler velocity parameters by Strandness, Washington, Faught, Bluth, Caroll and Beijing Xuanwu Hospital for grading internal carotid stenosis. The results were compared with those of angiography by ECST method. The sensitivity, specificity, positive predictive value （PPV）, negative predictive value （NPV） and Kappa value were calculated respec- tively. Results The sensitivity, specificity, PPV, NPV and Kappa value by Beijing Xuanwu Hospital were significantly higher than those by other standards. Conclusions Different institutions should establish the standard of Doppler velocity parameters for themselves. Our results suggest that the standard of Beijing Xuanwu Hospital is more accurate and has clinicl applicability in diagnosis of internal caroted stenosis.