彩色多普勒超声及血管超声造影对颈动脉狭窄或闭塞诊断的对比研究

Comparative Study of Color Doppler Ultrasound and Contrast-Enhanced Angiography in Diagnosis of Carotid Artery Stenosis or Occlusion

目的:比较彩色多普勒超声以及超声血管造影技术对颈动脉狭窄或闭塞患者的诊断价值,分析讨论二者诊断结果有差别的原因。方法:回顾性分析2016年1月~2019年12月在临床诊断上经同期进行超声血管造影检查及颈动脉彩色多普勒超声检查从而诊断为颈动脉狭窄症或颈动脉闭塞的300例患者的临床病例,作为本次试验的样本,通过一致性检验手段来检验彩色多普勒超声与超声血管造影的诊断结果的一致性,对于二者诊断结果不相一致的患者,给予再次进行颈动脉彩超以及血管造影的动态图像,分析二者的诊断结果不相一致的产生原因。结果:首次进行颈动脉彩超检查和超声血管造影检查的检查结果显示,其符合率达到92%(276/300),两种检查手段的结果一致性较好(Kappa=0.784,P<0.01)。结论:彩色多普勒超声检查颈动脉狭窄或闭塞与超声血管造影检查结果的一致性较好,对于部分患者的诊断结果不相一致的原因应该进行综合分析,提高其临床诊断的准确度,这两项检查的结果是具有互补性的。

Objective:To compare the diagnostic value of color Doppler ultrasound and ultrasound angiography in patients with carotid stenosis or occlusion,and to analyze and discuss the reasons for the difference between the two diagnostic results.Methods:The clinical cases of 300 patients with carotid stenosis or carotid occlusion diagnosed by ultrasonic angiography and carotid color Doppler ultrasonography from January 2016 to December 2019 were analyzed retrospectively as the sample of this tria.The consistency of the diagnostic results of color Doppler ultrasound and ultrasound angiography was tested by consistency test.For patients with inconsistent diagnostic results,the dynamic images of carotid color Doppler ultrasound and angiography were given again,and the causes of inconsistent diagnostic results were analyzed.Results:The results of the first carotid ultrasound and ultrasound angiography showed that the coincidence rate was 92%(276/300),and the results of the two methods were in good agreement(Kappa=0.784,P<0.01).Conclusion:The results of color Doppler ultrasound in carotid artery stenosis or occlusion are consistent with the results of ultrasound angiography.The reasons for the inconsistent diagnosis results of some patients should be comprehensively analyzed to improve the accuracy of clinical diagnosis.In conclusion,the results of these two examinations are complementary.