超声造影与常规超声诊断不同程度动脉狭窄的对比分析

Comparison between contrast-enhanced ultrasound and routine ultrasonography in diagnosis of artery stenosis of different degree

目的:对比超声造影与二维、彩色多普勒、频谱多普勒判定不同程度动脉狭窄的准确度.方法:30只兔腹主动脉采用针控线扎法制做成不同程度的动脉狭窄模型,同时采用常规超声与超声造影分别测量直径狭窄率,以数字减影血管造影(DSA)为标准,判定不同方法的诊断符合率并比较各项超声指标的可重复性.结果:各种方法与DSA结果的诊断符合率按由高到低排序依次为超声造影>频谱>彩色多普勒>二维;注入造影剂后不同狭窄程度时狭窄处与狭窄段上游收缩期峰值流速(PSV)均较造影前加快,但流速比值(SVR)造影前后无统计学差异,SVR1与SVR2的诊断符合率也无统计学差异;造影后直径狭窄率的观察者间一致性系数在中重度狭窄组高于其它超声方法.结论:超声造影对动脉狭窄的狭窄程度判定准确度高,观察者间一致性好,可用于临床动脉狭窄性疾病的诊断和随访.

AIM： To compare the accuracy between contrastenhanced ultrasound, 2-dimension, color Doppler and pulse Doppler ultrasonographies in the diagnosis of artery stenosis of different degree. METHODS： Thirty rabbits underwent routine uhrasonography, contrast-enhanced ultrasound and DSA to detect the percent diameter stenosis after abdominal aortas were ligated to 3 different degrees. Each rabbit repeated every examination three times. We compared the accuracy and reproducibility between the 4 kinds of uhrasonic methods. RESULTS ： The order of diagnosis accuracy rate for stenosis from high to low was contrast-enhanced ultrasound, pulse Doppler, color Doppler and 2-dimension. Peak systolic velocity increased after we injected contrast media, but systolic velocity rate（SVR） did not change. There was no difference in the accuracy rate of SVR before and after we injected contrast media. The Kappa between observers was higher in contrastenhanced ultrasound than in other methods. CONCLUSION： Contrast-enhanced ultrasound is an accurate method in assessing different degree artery stenosis with good reproducibility, and it can be applied in diagnosis and follow-up of the disease.