超微血管成像技术在颈部动脉夹层诊断中的价值

The value of superb microvascular imaging in the diagnosis of cervical artery dissection

目的探讨超微血管成像技术(SMI)在颈部动脉夹层诊断中的应用价值。方法收集42例本院神经内科于2017年6月-2021年6月诊断颈部动脉夹层的患者,评价超微血管成像与CTA/MRA+DSA检查方法在诊断颈部动脉夹层是否具有一致性,并对比分析超微血管成像的准确性、敏感性。结果42例颈部动脉夹层患者中颈动脉二维超声、超微血管成像、CTA/MRA+DSA的检出率分别是42.8%(18例)、90.4%(38例)、92.6%(39例)。DSA线样征最多见,19例,占48.7%,常规超声及超微血管成像均以壁内血肿最多见。超微血管成像检出颈部动脉夹层与CTA/MRA联合DSA相比有较好的一致性(Kappa=0.340,P=0.056);超微血管成像检出颈部动脉夹层明显优于颈动脉二维超声(Kappa=5.895,P=0.015);超微血管成像诊断颈部动脉夹层的ROC曲线下面积为0.966,提示超微血管成像诊断颈部动脉夹层有极高的准确率。结论超微血管成像技术在各型颈部动脉夹层的诊断中均有很高的临床应用价值。

Objective To evaluate the diagnostic value of superb microvascular imaging(SMI)in cervical artery dissection.Methods A total of 42 patients with cervical artery dissection diagnosed by the Department of Neurology of our hospital from June 2017 to June 2021 were collected to evaluate the consistency of SMI and CTA/MRA+DSA in the diagnosis of cervical artery dissection,and to compare the accuracy and sensitivity of SMI.Results Among 42 patients,the positive rate of cervical artery dissection with ultrasonography,SMI,CTA or MRA and DSA were 42.8%(18/42),90.4%(38/42)and 92.6%(39/42)respectively.The DSA mostly showed the line-like sign(n=19,48.7%);Ultrasonography and SMI mostly showed the intramural hematoma.SMI and CTA/MRA+DSA showed the good consistency in the diagnosis of cervical artery dissection(Kappa=0.340,P=0.056).Superb microvascular imaging was superior to ultrasonography in the detection of cervical artery dissection(Kappa=5.895,P=0.015).The area under the ROC superb microvascular imaging diagnosis of cervical artery dissection was 0.966.It is suggested that superb microvascular imaging has high accuracy in diagnose cervical artery dissection.Conclusion Superb microvascular imaging has high clinical value in the diagnosis of various types of cervical artery dissection.