血管彩超诊断中风患者颈动脉颅外病变的价值

Value of vascular color Doppler ultrasound in the diagnosis of carotid extracranial lesions in stroke patients

目的:研究血管彩超诊断中风患者颈动脉颅外病变的价值。方法:回顾性选取2019年1月—2020年9月我院收治的61例脑卒中患者临床资料分析,患者均接受血管彩超检查,并以神经内科数字减影血管造影为金标准;对比两种检查结果的颈动脉狭窄情况以及颈总动脉、颈内动脉颈外动脉斑块情况;对比两种检查方式准确率;对血管彩超诊断中风患者颈动脉颅外病变诊断价值分析。结果:61例患者总共检查122条颈动脉,经数字减影血管造影共检查出91条病变颈动脉;经过颈部彩色血管超声检查存在79条病变颈动脉;数字减影血管造影总共检查出221例板块;颈部彩色血管超声总共检查出218例,两种检查方式在颈总动脉检查结果差异不具有统计学意义(P>0.05);数字减影血管造影总共检查出121例颈内动脉斑块;颈部彩色血管超声总共检查出171例;颈部彩色血管超声颈内动脉斑块总数显著高于数字减影血管造影总共检查数(P<0.05);数字减影血管造影总共检查出81例颈外动脉斑块;颈部彩色血管超声总共检查出143例,颈部彩色血管超声颈外动脉斑块总数显著高于数字减影血管造影总共检查数,差异具有统计学意义(P<0.05);颈部彩色血管超声总共检查出79条狭窄动脉,准确率为86.81%,漏诊率为13.18%;经分析得出,颈部彩色血管超声灵敏度为86.81%,特异度为61.29%,阳性预测值为86.81%,阴性预测值为61.29%,准确率为80.33%。结论:血管彩超诊断中风患者颈动脉颅外病变的灵敏度和准确率一般,但是对于颈动脉的斑块病变检查率较高,同样也是诊断颈动脉颅外病变的重要检查方式。

Objective:To study the value of vascular color Doppler ultrasound in diagnosing carotid extracranial lesions in stroke patients.Methods:Sixty-one stroke patients admitted to our hospital from January 2019 to September 2020 were retrospectively select to analyze the clinical data,with vascular color Doppler ultrasound performed.With neurology digital subtraction angiography as the gold standard,the diagnostic accuracy for the carotid artery stenosis,the common carotid artery and internal/external carotid artery plaques of the two methods were compared.The diagnostic value of carotid artery extracranial lesions in patients with stroke was analyzed.Results:A total of 122 carotid arteries were examined in 61 patients,and a total of 91 abnormal carotid arteries were examined by digital subtraction angiography.There were 79 abnormal carotid arteries after cervical color vascular ultrasound examination;A total of 221 cases were detected by digital subtraction angiography;A total of 218 cases were detected by cervical color vascular ultrasonography(P>0.05).A total of 121 cases of internal carotid artery plaque were detected by digital subtraction angiography;A total of 171 cases were detected by cervical color vascular ultrasonography.The total number of internal carotid artery plaques by cervical color vascular ultrasonography was significantly higher than that of digital subtraction angiography(P<0.05).A total of 81 cases of external carotid artery plaques were detected by digital subtraction angiography;A total of 143 cases were detected by cervical color vascular ultrasonography.The total number of external carotid artery plaques by color vascular ultrasound in the neck was significantly higher than that of digital subtraction angiography(P<0.05).A total of 79 stenotic arteries were detected in the neck color vascular examination with an accuracy rate of 86.81%and a missed diagnosis rate of 13.18%.According to the analysis,the sensitivity of color blood vessels in the neck was 86.81%,the specificity was 61.29%,the positive predictive value was 86.81%,and the negative predictive value was 61.29%,and the accuracy was 80.33%.Conclusion:The sensitivity and the accuracy of vascular color Doppler ultrasound for carotid plaque detection is good,as well as for diagnosis of carotid extracranial lesions.