经颅多普勒超声联合颈动脉超声诊断椎基底动脉狭窄的临床价值

Jie-Wei Wang
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引用次数: 0

摘要

目的探讨经颅多普勒超声(TCD)联合颈动脉超声对椎基底动脉狭窄的诊断价值。方法选取诸暨市人民医院2016年3月至2018年12月收治的147例疑似椎基底动脉狭窄患者。TCD结合颈动脉超声诊断椎基底动脉狭窄,并进行X射线计算机断层造影(CTA)。根据CTA结果,分析TCD联合颈动脉超声对椎基底动脉狭窄的诊断准确性。结果以CTA为诊断金标准,分析TCD联合颈动脉超声对椎基底动脉狭窄的诊断价值。左椎动脉诊断的敏感性为86.42%,特异性为89.39%,阳性预测值为90.91%,阴性预测值为84.29%,基底动脉的阳性预测值和阴性预测值分别为81.69%、93.42%、92.06%和84.52%。TCD联合颈动脉超声和CTA对左椎动脉的诊断差异无统计学意义,结论TCD联合颈动脉超声检查是筛查椎基底动脉狭窄的有效方法,有助于发现患者病情,指导临床治疗,值得临床应用。关键词:超声、多普勒、经颅多普勒;超声、多普勒、彩色;基底动脉;椎动脉;颈动脉;X射线计算机断层摄影血管造影术;颅内动脉粥样硬化性狭窄
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Clinical value of transcranial Doppler ultrasonography combined with carotid ultrasonography in the diagnosis of vertebral-basilar artery stenosis
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
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期刊介绍: Since its inception, the journal "Chinese Primary Medicine" has adhered to the development strategy of "based in China, serving the grassroots, and facing the world" as its publishing concept, reporting a large amount of the latest medical information at home and abroad, prospering the academic field of primary medicine, and is praised by readers as a medical encyclopedia that updates knowledge. It is a core journal in China's medical and health field, and its influence index (CI) ranks Q2 in China's academic journals in 2022. It was included in the American Chemical Abstracts in 2008, the World Health Organization Western Pacific Regional Medical Index (WPRIM) in 2009, and the Japan Science and Technology Agency Database (JST) and Scopus Database in 2018, and was included in the Wanfang Data-China Digital Journal Group and the China Academic Journal Comprehensive Evaluation Database.
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