腔内凸阵探头检测颈内动脉病变的价值探讨

Value of endoluminal convex array probe in detecting internal carotid arterial disease

目的:探讨腔内凸阵探头在颈内动脉(ICA)疾病检测中的应用价值。方法:73例(146支)ICA进行高频线阵探头和腔内凸阵探头对比检查,观察ICA显示长度、彩色血流及血流频谱形态,测量收缩期峰值速度(PSV),其中18例DSA检查ICA狭窄者(单侧),还测量PSVICA/PSVCCA比值,比较两种方法评估狭窄程度的准确率。结果:146支ICA高频线阵探头检测其显示长度为(2.05±0.35)cm,PSV为(89.8±20.9)cm/s;腔内凸阵探头检测显示长度为(4.41±0.32)cm,PSV值为(116.8±35.1)cm/s,两组测值比较差异均具有统计学意义(P<0.05)。41支ICA高频线阵探头检测困难者,腔内凸阵探头均获得满意二维、彩色血流及频谱图。腔内凸阵探头检出31支ICA走行迂曲呈"V"或"S"等形态,而高频线阵探头仅检出19支异常血管形态。在18例DSA检查ICA狭窄为70%～99%者,高频线阵探头评估狭窄程度的准确率为72.2%,而腔内凸阵探头的准确率为94.4%。结论:腔内凸阵探头能显著增大ICA显示长度,对ICA中远段疾病的检测具有较大价值,可作为高频线阵探头检查困难者的有效补充手段。

Objective： To investigate the value of endoluminal convex anay probe in detecting internal carotid arterial（ICA） disease. Methods： 146 ICA of 73 cases were examined with endoluminal convex array probe and high-frequency linear probe respectively to collect following data： visible length, color Doppler appearance and peak systolic velocity （PSV）. PSVICA/PSVCCA ratio was calculated in 18 cases of unilateral ICA stenosis diagnosed with DSA to compare the accuracy of evaluating stenosis with two different probes. Result： Visible length and PSV from high-frequency linear probe are （2.05±0.35）cm and （89.8±20.9） cm/s and those from endoluminal convex array probe are （4.41±0.32）cm and （116.8±35.1）cm/s, the difference between them is significant （P〈0.05）. Satisfied grey and color Doppler images can be obtained with endoluminal convex array probe in 41 ICA which were difficult to be examined with high-frequency linear probe. Thirty-one ICA were detected twisting in ＂V＂ or ＂S＂ appearance with endoluminal convex array probe, while only 19 ICA were detected in abnormal appearance with high-frequency linear probe. For 18 ICA with 70%-99% stenosis diagnosed by DSA, the accuracy of diagnosis is 72.2% with high-frequency linear probe, but 94.4% with endoluminal convex array probe. Conclusion： Endoluminal convex array probe is an effective complement for ICA inspection with high-frequency linear probe because visible length of ICA could be significantly increased with endoluminal convex array probe which is valuable for detecting pathologic changes in middle or distal parts of ICA.