TCD与DSA在颈动脉狭窄诊断中的价值比较

Compared with the Value of TCD and DSAfor Diagnosis of Carotid Artery Stenosis

目的:比较经颅多普勒超声(TCD)与数字减影血管造影术(DSA)用于颈内动脉狭窄诊断的可靠性。方法:分别对本院2014年2月至2015年10月收治47例颈动脉狭窄性病变患者进行TCD和DSA检查,并对检查结果进行对比分析。结果:经TCD检查发现有94支颈动脉存在不同程度的狭窄,其中36支为轻度狭窄Ⅰ级、29支为中度狭窄Ⅱ级、27为支重度狭窄Ⅲ级、2支为完全狭窄Ⅳ级,而经DSA检查,37支轻度狭窄Ⅰ级、27支中度狭窄Ⅱ级、29支重度狭窄Ⅲ级、1支完全狭窄Ⅳ级。两者相比,TCD检查具有98.2%的灵敏性、92.1%的特异性以及89.1%的正确指数,两组差异无统计学意义(P>0.05),且Kappa值的一致性较好。结论:诊断颈动脉狭窄的金标准仍是DSA,但TCD检查具有易操作、检查快速且重复性好,且费用低、无创伤、耗时少等优点,在颈动脉狭窄的重要检查方面可广泛推广。

Objective:To compare the reliability of transcranial doppler(TCD)and digital subtraction angiography(DSA)indiagnose carotid artery stenosis.Methods:47patients with carotid artery stenosiswho were treated in our hospital between february 2014 to october 2015,they were diagnosed by CTA and DSA,and the inspection results were analyzed.Result:By TCD examination found 94 has different degree of carotid artery stenosis,36 branch of mild stenosisⅠ,29 branch of moderate stenosisⅡ,27 for severe stenosisⅢ,two for narrow Ⅳ completely,and after DSA examination,37,a mild stenosisⅠ,27 of them moderate stenosisⅡ Ⅲ,29 severe stenosis,1anarrow Ⅳ completely.Compared the two,TCD examination with 98.2%sensitivity and specificity of 92.1%and 92.1% of the index correctly,no statistically significant differences between the two groups(P > 0.05),and Kappa value consistency is better.Conclusion:The gold standard is still the DSA in the diagnosis of carotid stenosis,but TCD examination is easy to operate,fast examination,and good repeatability,and the advantages of low cost,no trauma,less time consuming,in important examination of carotid stenosis can be widely popularized.