经颅多普勒超声联合颈动脉超声诊断老年缺血性脑卒中的价值

Value of Transcranial Doppler Ultrasound Combined with Carotid Ultrasound in Diagnosis of Elderly Ischemic Stroke

目的:研究颈动脉超声联合经颅多普勒超声(TCD)在诊断老年缺血性脑卒中的优势。方法:选取2018年1月—2022年2月北京市第二医院收治的160例老年疑似缺血性脑卒中患者为研究对象均接受头颈部CT血管造影术(CTA)检查TCD及颈动脉超声检查。以CTA诊断结果为衡量标准,分析对比颈动脉超声、TCD单独及联合诊断缺血性脑卒中的效能及检出血管狭窄病变情况。结果:颈动脉超声、TCD及TCD联合颈动脉超声的特异度比较,差异无统计学意义(P>0.05);TCD联合颈动脉超声的准确度、敏感度高于颈动脉超声、TCD,差异有统计学意义(P<0.05)。TCD联合颈动脉超声血管狭窄病变的检出率与头颈部CTA检出结果更接近,高于颈动脉超声、TCD,差异有统计学意义(P<0.05)。结论:诊断老年缺血性脑卒中时,采用TCD联合颈动脉超声的准确度、敏感度高,可尽早明确诊断,为诊治提供依据。

Objective:To study the advantages of carotid ultrasound combined with transcranial Doppler ultrasound(TCD)in the diagnosis of senile ischemic stroke.Methods:A total of 160 elderly patients with suspected ischemic stroke who were admitted to Beijing Second Hospital from January 2018 to February 2022 were selected as the study subjects.All patients received head and neck CT angiography(CTA)examination,TCD and carotid ultrasound.The diagnostic results of CTA were used as the determination standard to analyze and compare the efficacy and the detection of vascular stenosis lesions among carotid ultrasound alone,TCD alone and carotid ultrasound combined with TCD.Results:There was no statistical difference in the specificity of carotid ultrasound alone,TCD alone and carotid ultrasound combined with TCD(P>0.05);the sensitivity and accuracy of carotid ultrasound combined with TCD were higher than those of carotid ultrasound alone and TCD alone,and the difference was statistically significant(P<0.05).The detection rate of TCD combined with carotid ultrasound for vascular stenosis lesions was closer to that of head and neck CTA,and was higher than that of carotid ultrasound alone and TCD alone,and the difference was statistically significant(P<0.05).Conclusion:TCD combined with carotid ultrasound has a high accuracy and sensitivity in the diagnosis of senile ischemic stroke,and can early confirm the diagnosis and provide a basis for diagnosis and treatment.