Benninger D H, Baumgartner Ralf W
Department of Neurology, University Hospital, Zürich, Switzerland.
Front Neurol Neurosci. 2006;21:70-84. doi: 10.1159/000092386.
Ultrasound allows the reliable exclusion of spontaneous dissection of the cervical internal carotid artery (sICAD) in patients with carotid territory ischemia. The possibility of falsely positive ultrasound findings indicates that cervical magnetic resonance imaging (MRI) and angiography must confirm ultrasonic suspicion of sICAD. The sensitivity of ultrasound for assessing sICAD which causes no carotid territory ischemia, but headache, neck pain, Horner syndrome, or palsy of the cranial nerves on the side of dissection is about 70%, and for identifying spontaneous dissection of the vertebral artery (sVAD) the sensitivity is 75-86%. The negative predictive value and specificity for ultrasound diagnosis of the latter two types of cervical artery dissection is unknown. Consequently, all patients with clinical suspicion of sICAD causing no ischemic event or sVAD should undergo cervical MRI and angiography. Ultrasound is useful for noninvasive monitoring of vessel recanalization and for determining the duration of antithrombotic therapy.
超声检查能够可靠地排除颈动脉供血区缺血患者的颈内动脉自发性夹层（sICAD）。超声检查结果出现假阳性的可能性表明，必须通过颈部磁共振成像（MRI）和血管造影来证实超声对sICAD的怀疑。对于评估未引起颈动脉供血区缺血，但导致头痛、颈部疼痛、霍纳综合征或夹层侧颅神经麻痹的sICAD，超声检查的敏感性约为70%，而对于识别椎动脉自发性夹层（sVAD），其敏感性为75%-86%。超声诊断后两种类型的颈动脉夹层的阴性预测值和特异性尚不清楚。因此，所有临床怀疑有未引起缺血事件的sICAD或sVAD的患者均应接受颈部MRI和血管造影检查。超声检查对于血管再通的无创监测以及确定抗血栓治疗的持续时间很有用。
