急性缺血性卒中大脑中动脉闭塞的经颅彩色编码实时超声检查标准

Transcranial color-coded real-time sonographic criteria for occlusion of the middle cerebral artery in acute ischemic stroke.

作者信息

Ogata Toshiyasu, Kimura Kazumi, Nakajima Makoto, Ikeno Kouichi, Naritomi Hiroaki, Minematsu Kazuo

机构信息

Department of Medicine, Cerebrovascular Division, National Cardiovascular Center, Osaka, Japan.

出版信息

AJNR Am J Neuroradiol. 2004 Nov-Dec;25(10):1680-4.

PMID:15569730

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8148747/

Abstract

BACKGROUND AND PURPOSE

Transcranial color-coded real-time sonography (TCCS) is a useful tool to evaluate disease of the middle cerebral artery (MCA). This study was undertaken to identify TCCS criteria for the diagnosis of MCA stem and MCA branch occlusions.

METHODS

TCCS and digital subtraction angiography were performed in 55 consecutive patients with acute stroke: 10 with MCA stem occlusion, the MO group; eight with MCA branch occlusion, the MB group; and 37 with nonocclusive lesions, the control group. We measured the end-diastolic velocity (EDV) of the bilateral MCA stems and calculated the end-diastolic ratio by dividing the EDV of the unaffected side by that of the affected side.

RESULTS

EDV was highest in the control group, and end-diastolic ratio was highest in the MO group. An EDV of >25 cm/s indicated a nonocclusive lesion in the MCA, with a positive predictive value of 98.4%, a negative predictive value of 81.0%, and an accuracy of 93.9%. An EDV of <or=25 cm/s with an end-diastolic ratio of <2.7 indicated an MCA branch occlusion with a positive predictive value of 85.7%, a negative predictive value of 97.2%, and an accuracy of 95.3%. An EDV of <or=25 cm/s with an end-diastolic ratio of >or=2.7 indicated MCA stem occlusion with a positive predictive value of 100%, a negative predictive value of 100%, and an accuracy of 100%.

CONCLUSION

We developed TCCS criteria for the diagnosis of MCA diseases. MCA flow velocity detected by means of TCCS can help identify MCA stem occlusion as well as MCA branch occlusion.

摘要

背景与目的

经颅彩色编码实时超声检查（TCCS）是评估大脑中动脉（MCA）疾病的有用工具。本研究旨在确定诊断MCA主干和MCA分支闭塞的TCCS标准。

方法

对55例连续急性卒中患者进行TCCS和数字减影血管造影：10例MCA主干闭塞患者，即MO组；8例MCA分支闭塞患者，即MB组；37例非闭塞性病变患者，即对照组。我们测量了双侧MCA主干的舒张末期流速（EDV），并通过将未受影响侧的EDV除以受影响侧的EDV来计算舒张末期比率。

结果

对照组的EDV最高，MO组的舒张末期比率最高。EDV>25 cm/s表明MCA存在非闭塞性病变，阳性预测值为98.4%，阴性预测值为81.0%，准确率为93.9%。EDV≤25 cm/s且舒张末期比率<2.7表明为MCA分支闭塞，阳性预测值为85.7%，阴性预测值为97.2%，准确率为95.3%。EDV≤25 cm/s且舒张末期比率≥2.7表明为MCA主干闭塞，阳性预测值为100%，阴性预测值为100%，准确率为100%。