彩色多普勒超声诊断锁骨下动脉狭窄特征的临床分析

Clinical analysis on the signficance of application of color Doppler flow imaging in diagnosis of subclavian artery stenosis

目的探讨锁骨下动脉狭窄性疾病的彩色多普勒超声(CDFI)检查方法,评价其可靠性,以提高此类疾病的超声诊断水平。方法回顾性分析2年来CDFI诊断的锁骨下动脉狭窄性病例(71例),CDFI检查包括二维超声观察血管管腔,彩色血流及频谱综合分析,评估血管的狭窄程度及特征。超声检查结果与CT血管造影(CTA)或数字减影血管造影(DSA)的结果对比,评价前者确诊及病变程度评估的准确性及可靠性。观察不同程度动脉狭窄患者椎动脉血流窃血情况。结果 CDFI诊断锁骨下动脉轻度狭窄26例,中度狭窄18例和重度狭窄或闭塞27例;诊断中度及以上狭窄的敏感性为95.6%,特异性为96.0%,阳性预测值为97.8%,阴性预测值为92.3%。随着病变程度增加,椎动脉内血流呈现逐渐演变的规律性变化,提示不同程度的窃血现象。结论与DSA或CTA的结果相比,CDFI诊断锁骨下动脉狭窄的价值和狭窄程度评估的结果是可靠的。

Objective To explore the application of Color Doppler Flow Imaging （CDFI） in diagnosis of subclavian artery stenosis and its reliability.Methods The data of 71 cases of subclavian artery stenosis diagosed by CDFI in this Department during past 2 years were retrospectively analyzed.The examination of CDFI included the measurement of of vessel lumina by 2-dimensional ultrasonography, and blood flow and spectrum, in order to evaluate the degree and characteristics of the stenosis of subclavian artery.The results of CDFI were compared with those of CT angiography （CTA） or digtal subtraction angiography （DSA）, in order to assess the accuracy and reliability of the diagnosis of CDFI.Results The number of cases with mild stenosis of subclavian artery identified by CDFI was 26 cases, and moderate and severe stenosis （occlusisn） were seen in 18 and 27 cases respectively.As for moderate and severe stenosis, the sensitivity and specificity of diagnosis were 95.6% and 96% respectively, and the positive and negative predictive values were 97.8% and 92.3% respectively.Conclusion In comparison with the results of CTA or DSA, the diagnosis of subclavian artery stenosis by CDFI is accurate and reliabile.