彩色多普勒超声与DSA诊断缺血性脑血管病患者颅外段颈动脉狭窄的对照研究

Controll Study on the Diagnosis of Extracranial Carotid Stenosis in Patients with Ischemic Cerebrovascular Disease with Color Doppler Flow Image and DSA

目的:探讨彩色多普勒超声(CDFI)和数字减影血管造影(DSA)在缺血性脑血管病患者颅外段颈动脉狭窄诊断中的价值。方法:选择50例缺血性脑血管病患者,分别行CDFI与DSA检查,以DSA检查结果为金标准,分析二者检查结果的一致性。结果:颈动脉狭窄CDFI检出率84.00%、DSA为76.00%,差异无统计学意义(P>0.05);两种方法检查显示颈动脉狭窄程度比较,差异无统计学意义(P>0.05)。CDFI检查显示颈动脉狭窄程度与DSA具有较好的一致性(Kappa值=0.7512,P<0.05)。CDFI检查诊断颈动脉的敏感性为88.10%,特异性为87.50%,准确性为88.00%,阳性.预测值为97.37%,阴性.预测值58.33%。结论:CDFI在颈动脉狭窄检出率及狭窄程度判定与DSA具有较好的一致性,无创伤,可重复好,适合于颅外段颈动脉狭窄的筛查。

Objective：To investigate the values of color doppler flow image（CDFI） and digital subtraction angiography（DSA） in diagnosing extracranial carotid stenosis in patients with ischemic cerebrovascular disease.Methods：A total of 50 patients with ischemic cerebrovascular disease were selected and examined by CDFI and DSA.With the DSA result as a gold standard,the concordance between the results of the two methods was analyzed.Results：The detectable rates of CDFI and DSA were 84.00%and 76.00%respectively,and the difference was statistically insignificant（P〉0.05）;and the two methods had insignificantly different results of degree of carotid stenosis（P〉0.05）.There was good concordance between the degree of carotid stenosis revealed by CDFI and that revealed by DSA（Kappa value = 0.7512,P〈0.05）.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of CDFI in diagnosis of carotid stenosis were 88.10%,87.50%,88.00%,97.37%,and 58.33%,respectively.Conclusion;CDFI is fairly accordant with DSA in detectable rate of carotid stenosis and judgment of the degree of the stenosis,without wound,repeatable,and is applicable to the screening of extracranial carotid stenosis.