经颅多普勒超声检测后循环动脉狭窄或闭塞的敏感性和特异性

Sensitivity and specificity of transcranial Doppler ultrasound in diagnosis of posterior circulation artery stenosis or occlusion

目的探讨经颅多普勒超声(TCD)检测后循环动脉狭窄或闭塞的敏感性和特异性。方法选择后循环脑梗死患者98例,进行TCD、颈部血管彩色超声、头颈磁共振血管成像(MRA)或CT血管成像(CTA)或数字减影血管造影术(DSA)检查,并进行对比分析。结果 TCD检查异常26例,共67支血管病变,血管影像(MRA/CTA/DSA)检查107支血管病变。TCD诊断后循环动脉狭窄或闭塞的敏感性55.14%,特异性97.91%。诊断椎动脉狭窄敏感性88.89%,特异性97.63%;诊断基底动脉狭窄敏感性46.43%,特异性94.29%;诊断大脑后动脉狭窄敏感性41.51%,特异性100%。结论 TCD检测后循环动脉狭窄或闭塞的特异性高,敏感性一般。TCD可以作为初步筛查后循环动脉狭窄或闭塞的方法,有助于后循环脑梗死患者病因的诊断。

Objective To study the sensitivity and specificity of transcranial Doppler ultrasound （TCD） in diagnosis of posterior circulation artery stenosis or occlusion. Methods Ninety-eight patients with acute posterior circulation cerebral stroke were included in this study. The findings in TCD examination, neck angiography,head MRA, CTA and DSA were compared and analyzed. Results The TCD examination showed lesions of 67 arteries in 26 patients and the MRA/CTA/ DSA revealed lesions of 107 arteries. The sensitivity and specificity of TCD were 55. 14~ and 97.91a//00 for the diagnosis of posterior circulation artery stenosis,88.89~ and 97.63~ for the di- agnosis of vertebral artery stenosis,46.43% and 94.29% for the diagnosis of basal artery steno sis,41.51% and 100~ for the diagnosis of posterior cerebral artery stenosis. Conclusion The specificity of TCD is high for the diagnosis of posterior circulation artery stenosis or occlusion and can thus be used in screening posterior circulation artery stenosis or occlusion and in diagnosing posterior circulation cerebral stroke.