摘要
目的：通过与cT血管成像（CTA）的对比研究，探讨经颅彩色多普勒超声（TCCD）在脑梗死患者脑动脉狭窄或闭塞诊断中的价值。方法：临床明确诊断的脑梗死患者125例纳入研究，男98例，女27例，平均年龄59．6岁，应用TCCD检测双侧大脑中动脉（MCA）、大脑前动脉（ACA）、后交通动脉（PcomA）、大脑后动脉（PCA）和基底动脉（BA）；依据CDFI、频谱多普勒表现结合颅外颈动脉、椎动脉的超声检查结果对患者脑梗死病因进行初步判断，并与CTA比较。结果：男性颞窗透声良好率为90．8％（89／98），明显高于女性的63．0％（17／27）（x2=12．74，P〈0．001）。排除颞窗透声差的19例患者后，颞窗透声良好的106例脑梗死患者TCCD诊断颅内动脉闭塞或狭窄的准确性、灵敏度和特异度分别为90．6％（96／106）、81．3％（39／48）和98．3％（57／58），阳性预测值和阴性预测值分别为97．5％（39／40）和86．4（57／66）。CTA的准确性、灵敏度和特异度分别为95．3％（101／106）、91．7％（44／48）和98．3％（57／58），阳性预测值和阴性预测值分别为97．8％（44／45）和93．4（57／61），两者无明显统计学差异。结论：TCCD作为一种无创的、可重复性高的检查方法，在颞窗透声良好的条件下，其在脑动脉闭塞或狭窄的诊断上具有媲美CTA的准确性和等同CTA的特异度及阳性预测值。
Purpose： This study was designed to explore the value of transcranial color - coded duplex ultrasonography （TCCD） in diagnosis of arterial occlusions or stenosis among the cerebral infarction pa- tients, and a comparison with computed tomography angiography （CTA） was performed. Methods： One hundred and twenty - five patients, who were clinically vertified as cerebral infarction, were examined by TCCD, including bilateral middle cerebral artery （MCA）, anterior cerebral artery （ACA）, posterior cerebral artery （PCA）, posterior communicating artery （PcomA） and basilar artery. Based on the CDFI and Doppler signals of aforementioned intracranial arteries and the outcome of the extracranial carotid arteries and vertebral arteries, we could initially extract the etiological factors of cerebral infarction. Results： The abilities of ultrasound beam to penetrate the temporal bone were 90.8% （89 of 98） in males and 63.0% （17 of 27） in females, the differences were shown with significant. After eliminating 19 pa- tients with insufficient temporal acoustic windows, among the 106 cerebral infarction patients with suf- ficient temporal acoustic windows, the accuracy, sensitivity and specificity of TCCD in the diagnosis of arterial occlusions or stenosis were 90.6% （96 of 106）, 81.3% （39 of 48） and 98.3% （57 of 58）, respec-tively. The positive predictive value was 97.5% （39 of 40） and negative predictive value was 86.4% （57 of 66） among the 106 patients. While the accuracy of CTA was 95.3% （101 of 106）, sensitivity was 91.7% （44 of 48）, specificity was 98.3% （57 of 58）, positive predictive value was 97.8% （44 of 45）, and negative predictive value was 93.4% （57 of 61） . Conclusion： As a non- invasive and highly repeatable method, when the temporal acoustic windows were sufficient, TCCD enabled the better accuracy and the same specificity and positive predictive value with CTA for the assessment of intracranial occlusions or stenosis. It was possible to efficiently improve the diagnosis of intracranial occlusions or stenosis when combining TCCD with CTA.
出处
《中国医学计算机成像杂志》
CSCD
北大核心
2012年第1期54-57,共4页
Chinese Computed Medical Imaging
基金
浦东新区科技发展基金创新资金项目(No.PKJ2009-Y10)~~
关键词
经颅彩色多普勒超声
CT血管成像
脑梗死
Transcranial color - coded duplex ultrasonography
Computed tomography angiography
Cerebral infarction
