[通过双功扫描、磁共振血管造影和数字减影血管造影评估颅外颈内动脉狭窄：一项对比研究]

[Assessment of extracranial internal carotid artery stenosis by duplex scanning magnetic resonance angiography and digital subtraction angiography: a comparative study].

作者信息

Guo D, Wang Y, Fu W

机构信息

Research Unit of Vascular Surgery, Zhongshan Hospital, Shanghai Medical University, Shanghai 200032, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2000 Feb;80(2):98-100.

PMID:11798743

Abstract

OBJECTIVE

To investigate the correlation between duplex scanning, magnetic resonance angiography (MRA), and digital subtraction angiography (DSA) in the evaluation of extracranial internal carotid artery (EICA) stenosis.

METHODS

All the examinations mentioned-above were performed on 32 patients. According to NASCET, EICA stenosis were classified into four grades: mild (the diameter reduction < 30%), moderate (31% approximately 69%), severe (70% approximately 99%), and total occlusion.

RESULTS

One (3.1%) patient suffered from acute brain infarction after DSA. To compare duplex with DSA, Kappa = 0.78, and by the use of a severe or a greater than 30% stenosis as a positive study, the sensitivity, specificity and accuracy were 78%, 95%, 92% and 97%, 91%, 94%, respectively. To compare MRA with DSA, Kappa = 0.73, and with the same criteria, the sensitivity, specificity and accuracy were 78%, 90%, 89% and 97%, 91%, 94%, respectively. In the evaluation where the results of duplex and MRA were in agreement, to compare duplex + MRA with DSA, Kappa = 0.93, and the sensitivity, specificity and accuracy in the diagnosis of severe stenosis were 100%, 95% and 96%, and the accuracy in the diagnosis of > 30% stenosis was 100%.

CONCLUSIONS

There is good correlativity between duplex scanning, MRA and DSA in the examination of EICA stenosis. A combination of duplex and MRA with their results in agreement may ultimately eliminate the need of DSA in the evaluation of EICA stenosis.

摘要

目的

探讨双功超声扫描、磁共振血管造影（MRA）和数字减影血管造影（DSA）在评估颅外颈内动脉（EICA）狭窄中的相关性。

方法

对32例患者进行上述所有检查。根据北美症状性颈动脉内膜切除术试验（NASCET）标准，EICA狭窄分为四级：轻度（直径缩小<30%）、中度（31%至69%）、重度（70%至99%）和完全闭塞。

结果

1例（3.1%）患者在DSA检查后发生急性脑梗死。双功超声与DSA比较，Kappa值=0.78，以重度或大于30%狭窄为阳性检查结果时，敏感性、特异性和准确性分别为78%、95%、92%以及97%、91%、94%。MRA与DSA比较，Kappa值=0.73，采用相同标准时，敏感性、特异性和准确性分别为78%、90%、89%以及97%、91%、94%。在双功超声和MRA结果一致的评估中，双功超声+MRA与DSA比较，Kappa值=0.93，重度狭窄诊断的敏感性、特异性和准确性分别为100%、95%、96%，>30%狭窄诊断的准确性为100%。