摘要
目的评估经颅多普勒超声（TCD）对颈内动脉（ICA）颅内段狭窄的诊断价值。方法对2011~2013年某院神经内科收治的329例首发症状为短暂性脑缺血发作（TIA）或脑卒中且具备脑血管狭窄危险因素的患者,在发病3d内先后行TCD及计算机断层扫描血管造影术（CTA）检查,进行自身对照,比较两种方法之间的差异;以CTA为诊断标准,确定ICA颅内段狭窄的血管条数,然后对CTA证实ICA颅内段狭窄的患者的TCD资料进行回顾分析,分别计算TCD诊断不同程度ICA颅内段狭窄的灵敏度、特异度、阳性预测值、阴性预测值、准确度并分析TCD诊断颅内动脉病变的价值。结果 （1）对颈内动脉颅内段狭窄病例,TCD敏感性是81.3%,特异性是94.3%,阳性预测值是70.9%,阴性预测值96.7%,准确度92.4%。（2）侧支循环开放,重度狭窄患者75.8%存在侧支循环开放,中度及轻度狭窄患者未见侧支循环开放病例。（3）对诊断ICA颅内段狭窄,TCD与CTA相比,差异无统计学意义。结论 TCD对ICA颅内段重度狭窄、闭塞的患者具有较高的诊断价值,可作为筛查颈内动脉颅内段狭窄的首选检查手段,可作为血管内支架置入血管成形术术前筛查及术后复查的手段。
Objective To evaluate the validity of transcranial Doppler（TCD） in diagnosing the stenosis of intracranial internal carotid artery. Methods Three hundred and twenty nine patients with first attack of acute ischemic stoke or TIA were studied use TCD and CTA examination with 3 days of the onset of sympotoms,patients with stenosis of intracranial internal carotid artery were detected by CTA. Retrospectively,we compared the results of TCD with those of CTA,and tried to investigate the validity of transcranial Doppler （TCD） in diagnosing the stenosis of intracranial internal carotid artery. Results Frist The analysis of the indexes of diagnostic value of TCD showe that the sensitivity 81.3%,specificity 94.3% ,positive predictive value 70.9% ,negative predictive value 96.7%,accurate rate 92.4%. Second The more severe of stenosis,the higher rate of collateral circulation supply occurred. In severe carotid stenosis 75.8% of cases found to have collateral circulation supply. No collateral supply was found in moderate and mild ICA stenosis. Third There was no statistical significance between TCD and CTA in diagnosing the stenosis of intracranial ICA （P〉O.05）. Conclusions TCD could be used as a preferred screening modatity to diagnose the stenosis of intracranial internal carotid artery and to evaluate the degree of stenosis,especially reliable and accurate for the 71%-97% stenosis. TCD is a convenient method to screen the stenosis of intracranial internal carotid artery before the operation of pcrcutaneous transluminal angioplasty and stenting （PTAS） and reexamine after PTAS.
出处
《中华保健医学杂志》
2013年第4期296-299,共4页
Chinese Journal of Health Care and Medicine
基金
四川省乐山市科技计划立项(13SZD148)
