经颅彩色多普勒超声血流参数对短暂性脑缺血发作患者颈动脉狭窄的诊断价值

The Value of Transcranial Color Code Sonography Blood Flow Parameters in the Diagnosis of Carotid Stenosis in Patients with Transient Ischemic Attack

为探讨经颅彩色多普勒超声(TCCS)血流参数对短暂性脑缺血发作(TIA)患者颈动脉狭窄的诊断价值,本研究选取TIA患者作为研究组,同期健康者为对照组,两组均给予DSA检查和TCCS检查,比较TCCS血流参数。以DSA检查结果为金标准,分析TCCS血流参数对颈动脉狭窄的诊断效能。结果显示,研究组颈动脉狭窄阳性侧收缩期峰值流速(PSV)、舒张末期流速(EDV)、平均流速(MFV)、搏动指数(PI)、阻力指数(RI)均高于阴性侧和对照组(P<0.05)。受试者工作特征曲线(ROC)分析结果显示,TCCS血流参数诊断颈动脉轻度狭窄、中度狭窄、重度狭窄的最佳截断点分别为PSV≥110 cm/s或MFV≥65 cm/s、PSV≥145 cm/s或MFV≥85 cm/s、PSV≥190 cm/s或MFV≥115 cm/s。最佳截断点TCCS血流参数诊断颈动脉轻度狭窄、中度狭窄、重度狭窄的符合率与DSA检查结果一致性良好(Kappa=0.875,P=0.000)。因此,TCCS血流参数可有效监测TIA患者血流动力学变化,对颈动脉狭窄具有较高的诊断价值。

To investigate the value of transcranial color code sonography(TCCS)blood flow parameters in the diagnosis of carotid stenosis in patients with transient ischemic attack(TIA).TIA patients were selected as the study group and healthy people in the same period were selected as the control group.Both groups were given DSA examination and TCCS examination.DSA examination results were used as the gold standard to analyze the diagnostic efficiency of TCCS blood flow parameters on carotid stenosis.The results showed that the PSV,EDV,MFV,PI and RI of the positive side of carotid stenosis in the study group were all higher than those of the negative side and the control group(P<0.05).ROC curve analysis results showed that,the best cut-off points of TCCS blood flow parameters in the diagnosis of mild,moderate and severe carotid stenosis were PSV≥110 cm/s or MFV≥65 cm/s,PSV≥145 cm/s or MFV≥85 cm/s,PSV≥190 cm/s or MFV≥115 cm/s,respectively.The coincidence rate of the best cut-off points of TCCS blood flow parameters in the diagnosis of mild,moderate and severe carotid stenosis was good agreement with DSA(Kappa=0.875,P=0.000).Therefore,TCCS blood flow parameters can effectively monitor the hemodynamic changes in patients with TIA,and have high diagnostic value for carotid stenosis.