超声血管增强成像技术联合脉冲多普勒检查对椎动脉近端狭窄的诊断价值

Diagnostic value of Clarify VE combined with pulsed wave Doppler in diagnosis of proximal vertebral artery stenosis

目的探讨超声血管增强成像(Clarify VE)技术联合脉冲多普勒(PW)对椎动脉近端狭窄的诊断价值。方法对202例椎动脉近端狭窄患者行PW、Clarify VE及DSA检查。结果 PW共检出185例近端狭窄,其中轻度狭窄85例,与DSA符合率为91.4%;中度狭窄42例,与DSA符合率为91.3%;重度狭窄58例,与DSA符合率93.2%。PW联合Clarify VE共检出192例椎动脉近端狭窄,其中轻度狭窄86例,与DSA符合率为91.6%;中度狭窄44例,符合率为95.6%;重度狭窄62例,与DSA符合率为98.6%。PW检查对椎动脉近端狭窄诊断敏感性为91.5%,与DSA诊断符合率为91.5%;Clarify VE与PW联合检查对椎动脉近端狭窄诊断敏感性95.0%,与DSA诊断符合率为95.0%。与Clarify VE联合PW检查比较,PW检查的总体符合率及敏感性显著降低(均P<0.05)。结论 Clarify VE联合PW技术更能够清晰显示椎动脉近端斑块及残余管腔,可快速有效诊断椎动脉狭窄程度,具有较高的临床应用价值。

Objective To evaluate the diagnostic value of Clarify VE combined with pulsed wave Doppler （PW） in diagnosis of proximal stenosis of vertebral artery. Methods PW, Clarify VE and DSA were undertaken to 202 patients with proximal stenosis of vertebral artery. Results PW showed proximal stenosis of vertebral artery was in 185 cases, among whom 85 cases in mild severity of stenosis, the coincidence rate of DSA was 91.4% ; 42 cases in medium stenosis, the coincidence rate of DSA was 91.3% ; and 58 cases in severe stenosis, the coincidence rate of DSA was 93.2%. Clarify VE combined with PW showed proximal stenosis of vertebral artery was in 192 patients, among whom 86 cases in mild stenosis, the coincidence rate of DSA was 91.6% ; 44 cases in medium stenosis, the coincidence rate of DSA was 95.6% ; and 62 cases in severe stenosis, the coincidence rate of DSA was 98.6%. The diagnostic sensitivity of PW was 91.5% , the coincidence rate of DSA was 91.5% ; the diagnostic sensitivity of Clarify VE combined with PW was 95.0% , the coincidence rate of DSA was 95.0%. Compared with Clarify VE combined with PW, the total coincidence rate of DSA and sensitivity of PW were significantly decreased （ all P 〈 0. 05）. Conclusion The technique of Clarify VE combined with PW enable distinctly reveals of plaques as well as the residual vessel lumen, which may be prompt and effective in diagnosis of proximal vertebral artery stenosis, and is fairly valuable in clinical applications.