颈动脉超声联合经颅彩色多普勒超声对缺血性脑卒中患者颈动脉狭窄的评估价值

Evaluation Value of Carotid Artery Stenosis in Patients with Ischemic Stroke Using Carotid Artery Ultrasound Combined with Transcranial Color Doppler Ultrasound

目的 分析颈动脉超声联合经颅彩色多普勒超声(TCCD)对缺血性脑卒中患者颈动脉狭窄的评估价值。方法 回顾性分析,采集2021年3月至2023年3月郑州大学附属郑州中心医院超声科就诊的120例缺血性脑卒中患者资料,患者的人口学资料、疾病资料、检查结果相关资料等均保存完整。120例缺血性脑卒中患者就诊后均接受颈动脉超声检查、TCCD检查、数字减影血管造影(DSA)检查,将DSA检查颈动脉狭窄结果作为金标准。记录颈动脉超声检查、颈动脉超声联合TCCD检查对缺血性脑卒中患者颈动脉狭窄的诊断结果情况。结果 120例缺血性脑卒中患者经金标准DSA检查均有不同程度的颈动脉狭窄,其中38例为颈动脉轻度狭窄,47例为颈动脉中度狭窄,29例为颈动脉重度狭窄,6例为颈动脉闭塞;将DSA检查结果作为金标准,颈动脉超声、颈动脉超声联合TCCD检查对缺血性脑卒中患者颈动脉狭窄的检出准确率分别为81.67%(98/120)、94.17%(113/120),二者与金标准诊断颈动脉狭窄的一致性K值分别为0.730、0.915,颈动脉超声与金标准的一致性一般,联合检查与金标准的一致性较好;颈动脉超声联合TCCD检查对缺血性脑卒中患者颈动脉狭窄的检出准确率及一致性均优于颈动脉超声。结论 颈动脉超声联合TCCD为缺血性脑卒中患者颈动脉狭窄的诊断提供了一种安全、可靠的检查方式,与金标准DSA检查的一致性较高,可对颈动脉狭窄的评估提供重要参考。

Objective To analyze the evaluation effect of carotid artery ultrasound combined with transcranial color doppler ultrasound(TCCD)on carotid artery stenosis in patients with ischemic stroke.Methods Retrospective analysis was conducted to collect the data of 120 patients with ischemic stroke who were treated in Department of Ultrasound of Zhengzhou Central Hospital Affiliated to Zhengzhou University from March 2021 to March 2023.The demography data,disease data,examination results and other relevant data of the patients were kept intact.Patients with ischemic stroke underwent carotid artery ultrasound examination,TCCD examination,and digital subtraction angiography(DSA)examination after treatment.The results of DSA examination for carotid artery stenosis were used as the gold standard.The diagnostic results of carotid artery ultrasonography and carotid artery ultrasound combined with TCCD examination for carotid artery stenosis in patients with ischemic stroke were recorded.Results All 120 patients with ischemic stroke underwent gold standard DSA examination with varying degrees of carotid artery stenosis.Among them,38 were mild carotid artery stenosis,47 were moderate carotid artery stenosis,29 were severe carotid artery stenosis,and 6 were carotid artery occlusion.DSA examination results was used as the gold standard,the accuracy of carotid artery ultrasound,carotid artery ultrasound combined with TCCD examination for detecting carotid artery stenosis in ischemic stroke patients was 81.67%(98/120)and 94.17%(113/120),respectively.The K value of consistency between the two and the gold standard for diagnosing carotid artery stenosis was 0.730 and 0.915,respectively.The consistency between carotid artery ultrasound and the gold standard was average,while the consistency between the combined examination and the gold standard was good.The accuracy and consistency of carotid artery ultrasound combined with TCCD examination in detecting carotid artery stenosis in patients with ischemic stroke were better than those of carotid artery ultrasound.Conclusion Carotid artery ultrasound combined with TCCD provides a safe and reliable examination method for the diagnosis of carotid artery stenosis in patients with ischemic stroke,with high consistency with the gold standard DSA examination,and can provide important reference for the evaluation of carotid artery stenosis.