彩色多普勒超声在颈动脉支架置入术中的应用价值

Application value of color Doppler ultrasound in carotid artery stenting

目的探讨彩色多普勒超声在支架置入术治疗颅外段颈动脉粥样硬化性狭窄中的作用。方法 49例因颅外段颈动脉粥样硬化性狭窄行自膨胀式颈动脉支架置入术的患者,在术前应用彩色多普勒超声测量狭窄处内径、狭窄率,与数字减影血管造影(DSA)比较;在术后1个月和术后12个月测量狭窄处内径、收缩期峰值流速(PSV)、舒张末期流速(EDV)及阻力指数(RI),并与术前比较。结果彩色多普勒超声测量的狭窄处内径及狭窄率与DSA测值比较差异无统计学意义(P>0.05);术后1个月与12个月比较,狭窄处内径、PSV、EDV及RI差异无统计学意义(P>0.05),与术前比较狭窄处内径均显著增大(P<0.05),PSV、EDV及RI均显著减小(P<0.05)。1例患者在术后12个月随访时发现支架内再狭窄,经DSA证实后再次行支架治疗。结论彩色多普勒超声对颅外段颈动脉粥样硬化性狭窄的诊断准确性较高,可用于支架置入术前颈动脉狭窄的初选和术后的疗效评价及随访。

Objective To explore the effect of color Doppler ultrasound （CDU） in treatment of extracranial carotid artery atherosclerotic stenosis with stent placement. Methods Forty - nine patients with self - expanding carotid artery stenting （CAS） because of extracranial carotid atheroselerotic stenosis were examined by CDU. The preoperative diameter and stenosis rate were measured, and the results were compared with those of digital subtraction angiography （DSA）. One month and 12 months after operation, the diameter of stenosis , the peak systolic velocity （PSV） , the end - diastolic velocity （EDV） and the resistance index （RI） were measured, and the results were compared with preoperative parameters. Results There was no significant difference of diameters of stenosis and stenosis rate between DSA and color Doppler ultrasound （ P 〉 0.05 ）. There was no significant difference of diameters of stenosis, PSV, EDV and RI after one month and after 12 months （P 〉 0.05 ）. Compared with before operation, the diameters of stenosis was significantly increased （ P 〈 0.05 ） , and PSV, EDV and RI were significantly decreased （ P 〈 0.05）. One patient was found restenosis in 12 months follow - up after operation which was confirmed by DSA, then CAS was performed again. Conclusion Color Doppler ultrasound has high accuracy in diagnosis of extracranial carotid atheroselerotic stenosis, it could be used for preoperative initial selection , postoperative effect assessment and follow -up.