Clinical value of transcranial Doppler ultrasonography combined with carotid ultrasonography in the diagnosis of vertebral-basilar artery stenosis

Abstract

Objective To investigate the clinical value of transcranial Doppler ultrasound(TCD) combined with carotid ultrasound in the diagnosis of vertebral-basilar artery stenosis. Methods From March 2016 to December 2018, 147 patients with suspected vertebrobasilar artery stenosis admitted to the People's Hospital of Zhuji were selected.TCD combined with carotid artery ultrasonography were used to diagnose vertebrobasilar artery stenosis, and X-ray computed tomography angiography (CTA) was performed.The diagnostic accuracy of TCD combined with carotid artery ultrasonography for vertebrobasilar artery stenosis was analyzed based on the results of CTA. Results The diagnostic value of TCD combined with carotid ultrasound for vertebrobasilar artery stenosis was analyzed by using CTA as diagnostic gold standard.The diagnostic sensitivity for left vertebral artery was 86.42%, specificity was 89.39%, positive predictive value was 90.91%, negative predictive value was 84.29%.The diagnostic sensitivity for right vertebral artery was 80.26%, specificity was 90.14%, positive predictive value was 89.71%, negative predictive value was 81.01%.The sensitivity, specificity, positive predictive value and negative predictive value for basilar artery were 81.69%, 93.42%, 92.06% and 84.52%.respectively.There were no statistically significant differences between TCD combined with carotid ultrasound and CTA in the diagnosis of left vertebral artery, right vertebral artery and basilar artery stenosis (Z=-0.360, -0.851, -0.828, all P>0.05). Conclusion TCD combined with carotid ultrasonography is an effective screening method for patients with vertebrobasilar artery stenosis, which is helpful to the detection of patients' condition and the guidance of clinical treatment, and is worthy of clinical application. Key words: Ultrasonography, doppler, transcranial; Ultrasonography, doppler, color; Basilar artery; Vertebral artery; Carotid arteries; X-ray computed tomography angiography; Intracranial atherosclerotic stenosis