经颅超声造影与常规超声诊断缺血性脑血管病的临床对比

Clinical comparison of contrast enhanced transcranial color-coded sonography and conventional ultrasound in the diagnosis of ischemic cerebrovascular disease

目的比较经颅超声造影(CE-TCCS)与常规超声诊断缺血性脑血管病(ICD)的临床价值。方法选择75例ICD接受计算机断层血管造影成像(CTA)、常规超声、CE-TCCS检查的患者,以CTA作对照,对比分析CE-TCCS与常规超声的诊断性能指标。结果(1)与造影前相比,Willis环、左侧大脑中动脉(LMCA)、右侧大脑中动脉(RMCA)、左侧大脑前动脉(LACA)、右侧大脑前动脉(RACA)、左侧椎动脉(LVA)、右侧椎动脉(RVA)、基底动脉(BA)清晰显示率在造影后均得到显著提高,造影前后比较差异均有统计学意义(P<0.01)。(2)检查的525支血管,其中278支经常规超声检查清晰显示,247支显示不清,清晰显示率53.0%,常规超声诊断ICD颅内动脉狭窄或闭塞的灵敏度13.9%,特异度54.9%。经CE-TCCS检查,512支清晰显示,13支显示不清,清晰显示率97.5%;CE-TCCS诊断ICD颅内动脉狭窄或闭塞的灵敏度为71.5%,特异度为95.7%。CE-TCCS的灵敏度、特异度均显著高于常规超声,差异有统计学意义(P<0.01)。结论CE-TCCS可以清晰显示颅内动脉,可用于ICD颅内动脉狭窄或闭塞的诊断。

Objective To compare the clinical values of contrast enhanced transcranial color-coded sonography(CE-TCCS)and conventional ultrasound in the diagnosis of ischemic cerebrovascular disease(ICD).Methods Seventy-five patients with ICD were given computed tomographic angiography(CTA),conventional ultrasound and CE-TCCS,and the results of CTA were defined as gold standard,then these diagnostic performance indexes between CE-TCCS and conventional ultrasound were compared.Results①Compared with those before radiography,the display rates of Willis ring,left middle cerebral artery(LMCA),right middle cerebral artery(RMCA),left anterior cerebral artery(LACA),right anterior cerebral artery(RACA),left vertebral artery(LVA),right vertebral artery(RVA)and basilar artery(BA)increased obviously after radiography(P<0.01).②There were 278 vessels displayed clearly and 247 vessels displayed vaguely via conventional ultrasound,and the display rate was 53.0%.The conventional ultrasound has a sensitivity of 13.9%and a specificity of 54.9%in the diagnosis of intracranial artery stenosis or occlusion in patients with ICD.There were 512 vessels displayed clearly and 13 vessels displayed vaguely via CE-TCCS,and the display rate was 97.5%.The conventional ultrasound has a sensitivity of 71.5%and a specificity of 95.7%.The sensitivity and specificity of CE-TCCS were obviously higher than those of conventional ultrasound(P<0.01).Conclusion The CE-TCCS can display the intracranial arteries clearly,which can be used for diagnosis of intracranial artery stenosis or occlusion in patients with ICD.