彩色多普勒血流成像在缺血性脑血管病患者颈动脉狭窄评估中应用价值分析

The value and indicators of color Doppler ultrasound in evaluating carotid artery lesions in patients with ischemic cerebrovascular disease

目的:探讨彩色多普勒血流成像(CDFI)在缺血性脑血管病患者颈动脉狭窄评估中的应用价值。方法:回顾性分析2021年1月—2023年11月寿光市人民医院收治的125例缺血性脑血管病患者颈动脉数字减影血管造影(DSA)及CDFI检查结果,以DSA结果为金标准分析CDFI诊断颈动脉狭窄的灵敏度、特异度、准确度、阳性预测值、阴性预测值,并用Kappa检验验证CDFI与DSA诊断颈动脉狭窄的一致性;根据DSA结果显示的颈动脉狭窄情况将患者分为颈动脉狭窄组与正常组,比较两组患者颈动脉血搏动指数(PI)、阻力指数(RI)、舒张期血流速度(EDV)、收缩期峰值流速(PSV)。结果:DSA结果显示,125例患者中74例存在颈动脉狭窄,设为颈动脉狭窄组;51患者无颈动脉狭窄,设为正常组。CDFI检查结果显示,125例患者中73例存在颈动脉狭窄,以DSA结果为金标准,CDFI诊断颈动脉狭窄的灵敏度为97.30%、特异度为98.04%、准确率为97.60%、阳性预测值为98.63%、阴性预测值为96.15%,且Kappa检验结果显示,CDFI与DSA诊断颈动脉狭窄的一致性极好(Kappa值=0.950,P<0.05)。颈动脉狭窄组患者PI、RI高于对照组,EDV、PSV低于对照组,差异有统计学意义(P<0.05)。结论:CDFI在缺血性脑血管病患者颈动脉狭窄评估中的应用价值较高,便于临床更好地对患者进行治疗,促进患者病情好转。

Objective To explore the value and flow imaging indicators of color Doppler ultrasound(CDFI)in the evaluation of carotid artery lesions in patients with ischemic cerebrovascular disease.Methods A retrospective analysis was conducted on 125 patients with ischemic cerebrovascular disease admitted to Shouguang People's Hospital from January 2021 to November 2023.All patients underwent CDFI examination for carotid artery lesions,and digital subtraction angiography(DSA)was used as the gold standard to measure the detection and diagnostic value of carotid artery lesions.Kappa test was used to verify the consistency between CDFI diagnosis of carotid artery lesions and the gold standard,to compare the differences in pulsatility index(PI),resistance index(RI),end-diastolic velocity(EDV),peak systolic velocity(PSV)between the carotid artery stenosis group and the normal group.Results Among the 125 patients,74 had carotid artery stenosis by DSA,and 73 had carotid artery stenosis by CDFI.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of CDFI were 97.30%,98.04%,97.60%,98.63%and 96.15%respectively.Kappa test showed that carotid CDFI diagnosis was in good agreement with the gold standard(Kappa value=0.950,P<0.05).The PI and RI of patients with carotid artery stenosis were higher than those in the control group,while the EDV and PSV were lower than those in the control group,with statistical significance(P<0.05).Conclusion The application value of CDFI in the evaluation of carotid artery stenosis in patients with ischemic cerebrovascular disease is high,which facilitates better clinical treatment of patients and promotes their condition improvement.