Chua Hoe-Chin, Sitoh Yih-Yian, Earnest Arul, Venketasubramanian N
Department of Neurology, National Neuroscience Institute, Tan Tock Seng Hospital, Singapore.
Ann Acad Med Singap. 2007 Apr;36(4):247-52.
Duplex ultrasonography is an excellent non-invasive screening tool for carotid artery stenosis. The aim of this study was to evaluate optimal ultrasonographic criteria for determination of internal carotid artery stenosis with reference to digital subtraction angiography.
From January 1995 to December 2003, 114 symptomatic patients underwent both duplex ultrasonography and angiography. Seven velocity criteria were compared with angiographic stenosis and receiver operating characteristic curves were used to determine the best cutoff for each criteria.
Internal carotid artery/common carotid artery systolic velocity ratios (PSV ICA/PSV CCA) and systolic internal carotid artery/diastolic common carotid artery ratios (PSV ICA/EDV CCA) were superior to other criteria for diagnosing internal carotid artery stenosis. For 50% stenosis, the best criterion of PSV ICA/PSV CCA was 1.5 [sensitivity 100%, specificity 85%, area under the curve (AUC) 99%], and the best criterion of PSV ICA/EDV CCA was 3.5 (sensitivity 100%, specificity 58%, AUC 99%). For 60% stenosis, the best criterion of PSV ICA/PSV CCA was 2.6 (sensitivity 100%, specificity 94%, AUC 99%), and the best criterion of PSV ICA/EDV CCA was 10.3 (sensitivity 100%, specificity 96%, AUC 99%). For 70% stenosis, the best criterion of PSV ICA/PSV CCA was 3.1 (sensitivity 100%, specificity 91%, AUC 99%), and the best criterion of PSV ICA/EDV CCA was 10.3 (sensitivity 100%, specificity 91%, AUC 99%).
Our study showed that velocity ratios are superior to other criteria for detecting carotid stenosis. Each laboratory needs to validate its own results.
双功超声检查是一种用于筛查颈动脉狭窄的出色无创工具。本研究的目的是参照数字减影血管造影术评估确定颈内动脉狭窄的最佳超声标准。
1995年1月至2003年12月，114例有症状的患者接受了双功超声检查和血管造影。将七个速度标准与血管造影狭窄情况进行比较，并使用受试者操作特征曲线来确定每个标准的最佳临界值。
颈内动脉/颈总动脉收缩期速度比（PSV ICA/PSV CCA）和颈内动脉收缩期/颈总动脉舒张期速度比（PSV ICA/EDV CCA）在诊断颈内动脉狭窄方面优于其他标准。对于50%狭窄，PSV ICA/PSV CCA 的最佳标准是1.5[敏感性100%，特异性85%，曲线下面积（AUC）99%]，PSV ICA/EDV CCA 的最佳标准是3.5（敏感性100%，特异性58%，AUC 99%）。对于60%狭窄，PSV ICA/PSV CCA 的最佳标准是2.6（敏感性100%，特异性94%，AUC 99%），PSV ICA/EDV CCA 的最佳标准是10.3（敏感性100%，特异性96%，AUC 99%）。对于70%狭窄，PSV ICA/PSV CCA 的最佳标准是3.1（敏感性100%，特异性91%，AUC 99%），PSV ICA/EDV CCA 的最佳标准是10.3（敏感性100%，特异性91%，AUC 99%）。
我们的研究表明，速度比在检测颈动脉狭窄方面优于其他标准。每个实验室都需要验证自己的结果。
