彩色多普勒超声在缺血性脑血管疾病患者颈动脉病变检测中的应用价值及影像学指标探析

Application value and imaging indexes of color Doppler ultrasound in detecting carotid artery lesions in patients with ischemic cerebrovascular disease

目的探讨彩色多普勒超声在缺血性脑血管疾病(ICVD)患者颈动脉病变检测中的应用价值及影像学指标。方法前瞻性抽取2021年8月至2023年8月南阳南石医院收治的ICVD患者120例,依据颈动脉狭窄情况将其分为无颈动脉狭窄组(47例)和颈动脉狭窄组(73例,其中轻度狭窄34例,中度狭窄25例,重度狭窄14例)。检测其颈总动脉(CCA)及颈内动脉(ICA)的血管内径(VD)、内膜中层厚度(IMT)、血流动力学参数[收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)、平均血流速度(MFV)]。采用Spearman相关性检验分析ICVD患者颈动脉狭窄程度与CCA、ICA影像学指标的关系。结果颈动脉狭窄组CCA和ICA的VD低于无颈动脉狭窄组,IMT、PSV、EDV、MFV高于无颈动脉狭窄组(P<0.05)。重度狭窄者CCA和ICA的VD低于中度狭窄者、轻度狭窄者,IMT、PSV、EDV、MFV高于中度狭窄者和轻度狭窄者(P<0.05);中度狭窄者CCA和ICA的VD低于轻度狭窄者,IMT、PSV、EDV、MFV高于轻度狭窄者(P<0.05)。Spearman相关性检验结果显示,ICVD患者颈动脉狭窄程度与CCA和ICA的VD呈负相关(r<0,P<0.05),与CCA和ICA的IMT、PSV、EDV、MFV呈正相关(r>0,P<0.05)。结论通过彩色多普勒超声检测ICVD患者颈动脉影像学指标,有助于了解颈动脉病变程度,对早期诊断、治疗ICVD具有重要意义。

Objective To investigate the application value and imaging indexes of color Doppler ultrasound in detecting carotid artery lesions in patients with ischemic cerebrovascular disease(ICVD).Methods A total of 120 patients with ICVD admitted to Nanshi Hospital of Nanyang from August 2021 to August 2023 were prospectively selected,and they were divided into non-carotid artery stenosis group(47 cases)and carotid artery stenosis group(73 cases,including 34 cases of mild stenosis,25 cases of moderate stenosis,and 14 cases of severe stenosis)according to occurrence of carotid artery stenosis.The vascular diameter(VD),intima-media thickness(IMT),and hemodynamic parameters including peak systolic velocity(PSV),end-diastolic velocity(EDV),and mean flow velocity(MFV)of the common carotid artery(CCA)and internal carotid artery(ICA)were measured.The Spearman correlation test was used to analyze the relationships between severity of carotid artery stenosis and imaging indexes of CCA and ICA in ICVD patients.Results The VD of CCA and ICA in the carotid artery stenosis group were lower than those in the non-carotid artery stenosis group,moreover,the IMT,PSV,EDV and MFV in the carotid artery stenosis group were higher than those in the non-carotid artery stenosis group(P<0.05).Compared with patients with moderate stenosis and patients with mild stenosis,patients with severe stenosis had lower VD of CCA and ICA,and had higher levels of IMT,PSV,EDV and MFV(P<0.05).Compared with patient with mild stenosis,patients with moderate stenosis had lower VD of CCA and ICA,and had higher IMT,PSV,EDV and MFV(P<0.05).The results of Spearman correlation test showed that the degree of carotid artery stenosis in ICVD patients was negatively correlated with the VD of CCA and ICA(r<0,P<0.05),and was positively correlated with IMT,PSV,EDV and MFV of CCA and ICA(r>0,P<0.05).Conclusions Detecting carotid artery imaging indexes in patients with ICVD by color Doppler ultrasound is helpful to master the degree of carotid artery lesions,and it has great significance for the early diagnosis and treatment of ICVD.