联合应用高频小凸阵及线阵探头评估颈部动脉粥样硬化性疾病的研究

Evaluation of carotid artery artherosclerosis with altotrequent convex lens probe and altotrequent linear array probe

目的联合应用高频线阵探头及高频小凸阵探头检测颈部动脉(椎动脉起始段及锁骨下动脉)内中膜厚度(IMT)、斑块形成情况,探讨联合应用高频线阵探头及高频小凸阵探头在颈部动脉粥样硬化性疾病诊断中的应用价值。方法对275例临床可疑颈部动脉粥样硬化性疾病的住院患者行颈部动脉超声检查(椎动脉起始段及锁骨下动脉),采用非随机对照方法,试验组采用高频线阵探头加用高频小凸阵探头,共观察135例;对照组采用高频线阵探头或加用低频凸阵探头,共观察140例;分别记录IMT、斑块形成等情况。其中有89例患者行颈动脉数字减影血管造影(DSA)检查。结果试验组患者颈部动脉IMT为(1.19±0.12)mm,而对照组为(1.12±0.13)mm(P<0.01);IMT增厚检出率及斑块形成检出率试验组为43.0%、74.8%,而对照组为32.1%、54.3%(P<0.01);以DSA作为标准对照,颈部血管超声诊断颈部动脉狭窄的灵敏度为96.8%,特异度为93.9%,随访临床符合率98.9%,与DSA检查对照符合率100%。结论联合应用高频线阵探头及高频小凸阵探头检测颈部动脉病变,局部动脉内膜显示率及硬化斑块检出率明显增高,局部血管狭窄漏诊情况减少。

Objective To assess the intima-media thickness （IMT） and atherosclerotic plaques of carotid artery. （initial segment of the vertebral artery and subclavical artery） with altotrequent convex lens probe and ahotrequent linear array probe （CLLA）, and to explore the value of diagnosis of the carotid artery stenosis with CLLA. Methods Two-hundred and seventy-five patients was enrolled in this study ,which was suspected to have carotid artery artherosclerosis disease. All the patients were divided into two groups：135 patients with CLLA, and the others with ahotrequent linear array probe or low frequency convex lens probe （LACL）, record the IMT and atherosclerotie plaques. Among them,89 patients had accepted the digital subtraction angiography （DSA） operation. Results IMT of carotid artery was （1.19±0.12） mm in CLLA group and there was （1.12±0.13 ）mm in LACL group （P〈0.01）. The rates of detection of IMT thickening and plaques in CLLA group were 43.0% and 74.8%. but there was 32.1% and 54.3% in LACL group （P〈0.01）. According the gold standard （DSA）, the sensitivity of ultrasound in diagnosis the carotid artery, stenosis was 96.8%, the specificity was 93.9%. The coincidence was 98.9% according to the clinic, and there was 100% according to DSA. Conclusion While using CLLA in diagnosis the carotid artery artherosclerosis, the rate of detected IMT and atherosclerotic plaques was increased obviously, and the rate of missed diagnosis in angiostegnosis was decreased.