彩色多普勒超声对颈动脉病变的诊断价值

The Diagnostic Values of Color Doppler Ultrasound in Patients with Carotid Artery Disease

目的评价颈部血管彩色多普勒超声(简称颈超)诊断颈内动脉颅外段病变的临床价值。方法对2006-2013年在宁夏医科大学总医院神经内科行数字减影血管造影(DSA)及颈超检查的595例患有脑血管病患者临床资料进行回顾性分析,以DSA为金标准分析颈超诊断颈内动脉颅外段病变的灵敏度、特异度等,并对不同狭窄程度的颈内动脉的检出情况进行比较。结果颈超检出颈内动脉病变的灵敏度为84.7%,特异度为61.4%,准确率为69.7%,漏诊率为15.3%,误诊率为38.6%;颈超对颈内动脉斑块的检出能力明显高于DSA(P<0.05),而DSA对颈内动脉管腔轻中重度狭窄及闭塞病变的检出明显高于颈超(P<0.05);颈超检查的灵敏度及准确率均呈年度递增趋势。结论颈超检出颈内动脉颅外段病变的特异度一般,但灵敏度高,准确率呈逐年递增趋势,且更擅长对颈内动脉斑块病变的检出,依然是诊断颈内动脉颅外段病变的重要手段。

Objective To evaluate the clinical values of neck vascular color doppler ultrasound( CDU) in diagnosing extracranial internal carotid artery disease. Methods This study was a retrospective analysis of 595 patients who had been examined by DSA and CDU in General Hospital of Ningxia Medical University from2006 to 2013. Using DSA as the'Gold standard',we analyzed the sensitivity and specificity of CDU in diagnosing extracranial internal carotid artery disease,and compared to the detection of different degree of stenosis of internal carotid artery. Results By CDU detecting the internal carotid artery disease,the sensitivity,specificity,accuracy,missed diagnosis rate and misdiagnosis rate were 84. 7%,61. 4%,69. 7%,15. 3% was and 38. 6%,respectively. The ability of CDU detecting the internal carotid artery plaque was significantly higher than that DSA( P < 0. 05). The ability of DSA detecting the different degree stenosis and occlusion of internal carotid artery was significantly higher than that of CDU( P < 0. 05). We also found the sensitivity and accuracy of CDU showed an annual increasing trend. Conclusion The specificity of CDU to extracranial internal carotid artery disease is common while its sensitivity is well and the accuracy showed an increasing trend. CDU showed more effective for detection of internal carotid artery plaque lesions,So that CDU still played an important rule in diagnosis extracranial internal carotid artery disease.