颈部血管超声对于缺血性脑血管疾病的诊断价值研究

Diagnostic Value of Cervical Vascular Ultrasound in Patients with Ischemic Cerebrovascular Disease

目的:评价颈部血管超声在诊断缺血性脑血管疾病的准确性及临床价值。方法:收集2015年3月-2017年3月泰安市中医二院治疗的63例缺血性脑血管疾病患者作为观察组,收集同期健康体检的人员63例作为对照组。所有人员均采用东芝SSA-790型彩色多普勒超声诊断仪进行检查。比较两组观察斑块发生的位置、回声及颈动脉内部超声学表现,检查颈动脉血流搏动指数(PI)、血流阻力指数(RI)及血流速度(V)变化。结果:观察组检出颈动脉斑块46例(斑块总数220块),斑块发生率为73.0%;斑块发生在颈外动脉近段5例,占10.9%;发生在颈内动脉近段11例,占23.9%;发生在颈动脉主干7例,占15.2%;发生在颈动脉分叉处23例,占50.0%。220块斑块中低回声斑块92块,强回声斑块57块,混合回声斑71块。对照组检出颈动脉斑块2例(斑块总数5块),斑块发生率为7.9%,其中低回声斑块2块,强回声斑块2块,混合回声斑1块。两组检出率比较,差异均有统计学意义(P<0.05)。观察组颈动脉内中膜厚度增厚11例,占17.5%;颈动脉狭窄13例,占20.6%。对照组颈动脉内中膜厚度增厚1例,占1.6%;颈动脉狭窄1例,占1.6%。两组颈动脉内部超声学表现比较,差异具有统计学意义(P<0.05)。观察组颈动脉PI、颈动脉RI高于对照组,颈动脉V低于对照组,差异均有统计学意义(P<0.05)。结论:颈部血管超声有助于诊断缺血性脑血管疾病,具有较高的临床应用价值,值得临床进一步推广应用。

Objective: To evaluate the accuracy and clinical value of cervical vascular ultrasound in the diagnosis of ischemic cerebrovascular diseases. Methods: A total of 63 patients with ischemic cerebrovascular disease treated in Taian No. 2 TCM Hospital from March 2015 to March 2017 were collected as the observation group, and 63 healthy persons who underwent physical examination during the same period were collected as the control group. All the subjects were examined by Toshiba SSA-790color Doppler ultrasound diagnostic instrument. The plaque location, echo and internal carotid ultrasound manifestations were compared between the two groups, and the changes of carotid pulse index(PI), blood flow resistance index(RI) and blood flow velocity(V) were examined. Results: In the observation group, 46 cases(220 plaques in total) of carotid artery plaques were detected, with a plaque incidence of 73.0%, including 5 cases(10.9%) in the proximal segment of external carotid artery, 11 cases(23.9%) in the proximal segment of internal carotid artery, 7 cases(15.2%) in the main carotid artery, and 23 cases(50.0%) in the bifurcation of carotid artery. Among the 220 plaques, 92 were low echo plaques, 57 were strong echo plaques and 71 were mixed echo plaques. In the control group, 2 cases(5 plaques in total) of carotid artery plaques were detected, with a plaque incidence of7.9%, including 2 low echo plaques, 2 strong echo plaques and 1 mixed echo plaque. There was significant difference in the detection rate between the two groups(P<0.05). In the observation group, 11 cases(17.5%) had the carotid intima-media thickening, and 13 cases(20.6%) had carotid stenosis. In the control group, 1 case(1.6%) had the carotid intima-media thickening and 1 case(1.6%) had carotid stenosis. By comparing Internal carotid ultrasonography, the two groups had significant difference(P<0.05). The carotid PI and RI in the observation group were higher than those in the control group, while the carotid artery V was lower than that in the control group, with significant difference(P<0.05). Conclusion: Cervical vascular ultrasound is helpful for the diagnosis of ischemic cerebrovascular disease, has high clinical application value, and is worthy of further clinical application.