二维超声联合彩色多普勒血流超声诊断下肢动脉狭窄的价值分析

Application value of 2DUS combined with CDFI in the diagnosis of patients with lower extremity arterial stenosis

目的探讨二维超声(2DUS)联合彩色多普勒血流超声(CDFI)在下肢动脉狭窄诊断中的应用价值。方法选择2016年10月至2018年10月于大同市第三人民医院进行动脉数字减影血管造影(DSA)检查并诊断为下肢动脉狭窄患者238例作为研究对象,对其进行2DUS联合CDFI检查,将其检查结果与DSA检查结果进行比较和分析。结果2DUS联合CDFI显示,狭窄动脉有增厚、钙化、血栓、斑块等,表现为五彩镶嵌样血流信号,血管腔无回声暗区消失,有实性回声等;2DUS联合CDFI诊断238例患者下肢动脉轻度狭窄(235个节段)、中度狭窄(174个节段)、重度狭窄(123个节段)与DSA诊断对应数值比较差异均未见统计学意义(P均>0.05);2DUS联合CDFI的准确度为95.20%,灵敏度为90.07%,特异度为97.12%,阳性预测值为92.11%,阴性预测值为96.32%。结论2DUS联合CDFI诊断下肢动脉狭窄准确度、特异性、灵敏度较好,整体优势突出,有望取代DSA成为下肢动脉狭窄病变的首选诊断方式。

Objective To investigate the application value of two-dimensional ultrasound (2DUS) combined with color Doppler flow imaging (CDFI) in the diagnosis of patients with lower extremity arterial stenosis. Methods A total of 238 patients who were diagnosed as lower extremity arterial stenosis by digital subtraction angiography (DSA) in the Third People’s Hospital of Datong from October 2016 to October 2018 were enrolled in this study. All patients were given 2DUS combined with CDFI examination. The examination results were compared and analyzed with DSA results. Results 2DUS combined with CDFI found thickening, calcification, thrombosis and plaques in stenotic arteries, manifesting multicolored mosaic blood flow signals, disappeared echoless dark area in vessel lumen and solid echo. Number of mild stenosis (235 segments), moderate stenosis (174 segments) and severe stenosis (123 segments) among 238 patients with lower extremity arterial stenosis diagnosed by 2DUS combined with CDFI were not significantly different form that diagnosed by DSA(P>0.05). The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of 2DUS combined with CDFI were 95.20%, 90.07%, 97.12%, 92.11% and 96.32%, respectively. Conclusions 2DUS combined with CDFI has good accuracy, specificity and sensitivity in the diagnosis of lower extremity arterial stenosis, and it has prominent overall advantage. It is expected to replace DSA as the first choice for the diagnosis of lower extremity arterial stenosis.