先天性颈内动脉发育不良的超声诊断价值

Diagnostic value of ultrasound for congenital internal carotid artery hypoplasia

[目的]探讨先天性颈内动脉发育不良的超声诊断价值。[方法]回顾性收集2022年7月—2023年12月在包头市中心医院超声诊断为先天性颈内动脉发育不良的患者,记录所有患者一般资料、超声及影像学资料。[结果]25317例颈动脉超声检查受检者中有13例患者确诊为先天性颈内动脉发育不良,发生率为0.051%。13例先天性颈内动脉发育不良患者包括11例单侧颈内动脉发育不良和2例双侧颈内动脉发育不良,颈动脉管CT扫描证实13例颈内动脉发育不良患者均为单侧病变,其中2例单侧病变患者超声误诊为双侧病变,误诊率为15%。以CT扫描颈动脉管发育不良为金标准,绘制ROC曲线评价超声对先天性颈内动脉发育不良的诊断价值,曲线下面积(AUC)为0.941,先天性颈内动脉发育不良的最佳诊断界值为3.2 mm,灵敏度为100%,特异度为85%;超声检查方法与CT扫描颈动脉管的金标准检验方法的一致性检验显示Kappa值为0.846。[结论]超声诊断先天性颈内动脉发育不良有较高的诊断价值,可作为临床首选检查方法。

Aim To investigate the value of ultrasound in the diagnosis of congenital internal carotid artery hypoplasia(CICAH).Methods Patients diagnosed with CICAH by ultrasound in Baotou Central Hospital,Inner Mongolia from July 2022 to December 2023 were retrospectively collected.The general data,ultrasound and imaging data of all patients were recorded.Results Among the 25317 carotid artery ultrasonography subjects,13 patients were diagnosed as CICAH.The ultrasonic detection rate of CICAH was 0.051%.The 13 cases of CICAH included 11 cases of unilateral internal carotid artery hypoplasia and 2 cases of bilateral internal carotid artery hypoplasia.CT scan of carotid canal confirmed that all 13 cases of internal carotid artery hypoplasia were unilateral lesions,among which 2 cases of unilateral lesions were misdiagnosed as bilateral lesions by ultrasound,with a misdiagnosis rate of 15%.Taking carotid canal dysplasia as the gold standard,ROC curve was plotted to evaluate the diagnostic value of ultrasound in CICAH.The area under the curve(AUC)was 0.941,and the optimal diagnostic threshold value of CICAH was 3.2 mm,sensitivity was 100%,and specificity was 85%.The consistency test between ultrasonic examination and gold standard test method for CT scanning of carotid artery canal showed that Kappa value was 0.846.Conclusion Ultrasound has a high diagnostic value in the diagnosis of CICAH,and can be used as the first choice of clinical examination.