三维能量多普勒与彩色多普勒超声对颈动脉狭窄诊断的对比研究

The comparison of three-dimensional power Doppler imaging and color Doppler flow imaging in the diagnosis of carotid artery stenosis

目的比较三维能量多普勒超声（3D-PDI）与二维彩色多普勒血流显像（CDFI）在颈动脉狭窄诊断中的应用，探讨3D-PDI在颈动脉狭窄中的诊断价值。方法49例经CDFI诊断为颈动脉狭窄的患者，进行自由臂模式3D-PDI．测量血管内斑块及动脉狭窄的情况，并于1周内进行数字减影血管造影（DSA）检查，同时与CDFI比较。结果3D-PDI可直观显示狭窄区的立体形状，包括斑块数量、狭窄部位、血管腔大小及血流空间走行等征象。3D-PDI与CDFI测量颈动脉内径狭窄率比较，差异无统计学意义[（52．（1±0．9）％对（51．7±0．8）％，P〉0．05]；3D-PDI测量的颈动脉面积狭窄率与CDFI面积狭窄率比较，差异有统计学意义[（58．0±0．2）％对（52．0±0．5）％，P〈0．01]。狭窄分级中，CDFI、3D-PDI诊断颈动脉轻度、中度和重度狭窄比较，差异有统计学意义（P〈0．05）。3D-PDI与DSA诊断颈动脉狭窄程度结果差异无统计学意义（x^2=0．0538，P〉（1．05）；3D-PDI与CDFI对颈动脉分叉处的斑块数量检出率比较，差异有统计学意义（P〈0．01）。结论3D-PDI检测颈动脉狭窄、斑块的准确性优于CDFI，能为颈动脉狭窄的诊断及治疗提供更丰富的信息。

Objective To compare the diagnosis value of three dimensional power Doppler imaging （3D-PDI） and color Doppler flow imaging（CDFI） on carotid artery stenosis. Methods Forty-nine patients with carotid artery atherosclerosis plaque or stenosIs diagnosed by CDFI were enrolled in the study. The degree and ratio of carotid artery stenosis were measured by 3D-PDI in free hand mode, and measured by DSA in one week, the results were compared with CDFI. Results 3D-PDI of normal carotid artery with atheromatous plaque showed the stereo image, quantity character and exact position of plaque, volume of vessel lumen and spatial distribution of blood flow directly. There was no statistical difference in diameter stenosis rate between 3D-PDI and CDFI E（52.0 ± 0.9）% vs （51.7 ± 0.8）%, P 〉0.05],and the area stenosis rate measured by CDFI was significantly lower than that by 3D-PDI [（58.0 ± 0.2）% vs （52. 0 ± 0. 5）%, P 〈0.01 ]. In the diagnosis of stenosis classification, the rates o17 light,mild and severe stenosis were significantly different between CDFI and 3d-PDI（ P 〈0.05） and not significantly between 3D-PDI and DSA methods （x^2 = 0.0538, P 〉0. 05）. The detection rates of atherosclerotic plaques numbers in carotid crotch were significantly different between 3D-PDI and CDFI （ P 〈0. 05）. Conclusions 3D PDI can offer more valuable information for the diagnosis and trentment of carotid artery stenosis,it is more accurate than CDFI and similar to DSA.