三维颈动脉超声对颈动脉狭窄的诊断价值

Value of three-dimensional carotid ultrasound in the diagnosis of carotid stenosis

目的:分析三维颈动脉超声对颈动脉狭窄的诊断价值,为其临床应用提供依据。方法:回顾性分析2017年10月至2019年2月于聊城市人民医院接受诊治的81例颈动脉狭窄患者的临床资料。以数字减影血管造影(DSA)检查为金标准,计算三维颈动脉超声诊断颈动脉狭窄的准确度、特异度、灵敏度、阳性预测值与阴性预测值;计算三维颈动脉超声诊断不同程度颈动脉狭窄的符合率,评价三维颈动脉超声对颈动脉狭窄的诊断价值。结果:三维颈动脉超声检查诊断颈动脉狭窄的准确度为92.59%(150/162),特异度为92.86%(65/70),灵敏度为92.39%(85/92),阳性预测值为94.44%(85/90),阴性预测值为90.28%(65/72)。三维颈动脉超声诊断轻度狭窄、中度狭窄、重度狭窄、闭塞的符合率分别为81.48%(22/27)、93.94%(31/33)、100.00%(19/19)、100.00%(13/13),且三维颈动脉超声诊断与金标准的一致性Kappa值=0.895,一致性高。结论:三维颈动脉超声对颈动脉狭窄的诊断价值较高,能准确诊断不同程度的颈动脉狭窄,对于不适宜DSA检查的患者可采用三维颈动脉超声检查。

Objective:To analyze the diagnostic value of three-dimensional carotid ultrasound for carotid artery stenosis,and to provide a basis for clinical application.Methods:Clinical data of 81 patients with carotid artery stenosis who were treated in East Hospital of Liaocheng People’s Hospital from October 2017 to February 2019 were retrospectively analyzed.The accuracy,specificity,sensitivity,positive predictive value,and negative predictive value of three-dimensional carotid ultrasound in diagnosing carotid artery stenosis were calculated with digital subtraction angiography(DSA)as the gold standard.The coincidence rate of three-dimensional carotid ultrasound in diagnosing different degrees of carotid stenosis was calculated,and the value of three-dimensional carotid ultrasound in diagnosing carotid stenosis was evaluated.Results:The accuracy,specificity,sensitivity,positive predictive value,and negative predictive value of three-dimensional carotid ultrasound in diagnosing carotid stenosis were 92.59%(150/162),92.86%(65/70),92.39%(85/92),94.44%(85/90)and 90.28%(65/72),respectively.The coincidence rate of three-dimensional carotid ultrasound in diagnosing mild stenosis,moderate stenosis,severe stenosis,and occlusion were 81.48%(22/27),93.94%(31/33),100.00%(19/19),and 100.00%(13/13),respectively;and the consistency of three-dimensional carotid ultrasound diagnosis with gold standard was high,Kappa value=0.895.Conclusions:Three-dimensional carotid ultrasound has high diagnostic value for carotid stenosis,and it can accurately diagnose different degrees of carotid stenosis.For patients who could not undergo DSA examination,three-dimensional carotid ultrasound can be used.