经颅彩色多普勒超声联合经颅超声造影诊断颅内椎-基底动脉狭窄闭塞的价值

Value of transcranial color-coded sonography combined with contrast-enhanced transcranial color-coded sonography in diagnosis of intracranial vertebrobasilar artery stenosis or occlusion

目的探讨经颅彩色多普勒超声(TCCS)联合经颅超声造影诊断颅内椎-基底动脉狭窄闭塞的特征及准确性。方法对35例疑有椎-基底动脉狭窄闭塞的患者应用TCCS联合经颅超声造影经枕窗检查椎-基底动脉,同时与数字减影血管造影(DSA)比较。结果 35例患者DSA检出椎-基底动脉狭窄29支,TCCS联合经颅超声造影检出椎-基底动脉狭窄24支。与DSA检查对照,TCCS联合经颅超声造影诊断椎-基底动脉狭窄的差异无统计学意义(P>0.05),其诊断敏感性为79.31%,特异性为98.68%,阳性预测值为95.83%,阴性预测值为92.59%。结论 TCSS联合经颅超声造影能有效评估颅内椎-基底动脉的血流变化,可以作为大部分颅内椎-基底动脉狭窄闭塞病变的首选筛查手段。

Objective To explore the features and accuracy of transcranial color-coded sonography （TCCS） combined with contrast-enhanced transcranial color-coded sonography （CE-TCCS） in the diagnosis of intracranial vertebrobasilar arteries stenosls or occlusion. Methods Thirty-five patients who were suspected with intracranial vertebrobasilar arteries stenosis were examined by TCCS and CE-TCCS. The shape and course of every intracranial vertebrobasilar arteries were observed.All results were compared with DSA. Results In 35 patients, 29 vertebrobasilar artery stenosis were detected by DSA, and 24 vertebrobasilar artery stenosis were detected by TCCS and CE-TCCS. Compared with DSA, the sensibility, specificity, positive predictive value and negative predictive value of diagnosing vertebrobasilar artery stenosis using TCCS and CE-TCCS were 79.31%, 98.68%, 95.83% and 92.59%, respectively. Conclusion TCCS combined with CE-TCCS can assess effectively hemodynamic parameters of intracranial vertebrobasilar arteries, which can become the first choice to diagnose intracranial vertebrobasilar arteries stenosis or occlusion.