Lyrer P, Bont A, Marugg A, Operschall C, Radü E W
Neurologische Universitätsklinik, Abteilung zerebrale Ultraschalldiagnostik, Basel.
Ultraschall Med. 1999 Aug;20(4):137-43. doi: 10.1055/s-1999-8901.
In patients with atherosclerotic extracranial internal carotid artery (ICA-) stenosis the diagnostic value of colour Doppler energy (CDE)-coded duplexsonography was compared to three other methods: continuous wave (cw) Doppler peak systolic frequency (pF), pulsed wave (pw) Doppler peak systolic velocity (pV), and intraarterial digital subtraction angiography.
In 58 patients who suffered from 60 moderate to severe ICA stenoses, B-mode sonography combined with CDE-coded duplex sonography was applied to measure the extent of the stenosis by determining the residual lumen width. Results were correlated to pF and pV and with various angiographic indices.
The determined values of the degree of stenosis were correlated to the measurement of pV (r = 0.441, p < 0.01), but not to pF (r = 0.122, n.s.). The best correlation to angiography was obtained when the linear ICA diameter was compared to the distal common carotid artery (common carotid artery index) (r = 0.214, n.s.). Sensitivity, specificity and diagnostic accuracy were comparable to the different frequency-based measurements, but the positive predictive value was lower.
Determination of the degree of stenosis based on CDE alone is not reliable enough to allow correct diagnosis of severe carotid artery stenosis. In combination with the peak frequency method is's diagnostic value could be improved. This requires verification in a separate study.
在患有动脉粥样硬化性颅外颈内动脉（ICA）狭窄的患者中，将彩色多普勒能量（CDE）编码双功超声检查的诊断价值与其他三种方法进行比较：连续波（cw）多普勒收缩期峰值频率（pF）、脉冲波（pw）多普勒收缩期峰值速度（pV）以及动脉内数字减影血管造影。
对58例患有60处中度至重度ICA狭窄的患者，应用B型超声检查结合CDE编码双功超声检查，通过测定残余管腔宽度来测量狭窄程度。将结果与pF、pV以及各种血管造影指标进行相关性分析。
所测定的狭窄程度值与pV测量值相关（r = 0.441，p < 0.01），但与pF不相关（r = 0.122，无统计学意义）。当将颈内动脉的线性直径与远端颈总动脉进行比较（颈总动脉指数）时，与血管造影的相关性最佳（r = 0.214，无统计学意义）。敏感性、特异性和诊断准确性与不同的基于频率的测量方法相当，但阳性预测值较低。
仅基于CDE测定狭窄程度不足以可靠地正确诊断严重颈动脉狭窄。与峰值频率法联合使用可能会提高其诊断价值。这需要在另一项研究中进行验证。
