Oates C P, Naylor A R, Hartshorne T, Charles S M, Fail T, Humphries K, Aslam M, Khodabakhsh P
Regional Medical Physics Department, Freeman Hospital, Newcastle Upon Tyne NE4 6BE, United Kingdom.
Eur J Vasc Endovasc Surg. 2009 Mar;37(3):251-61. doi: 10.1016/j.ejvs.2008.10.015. Epub 2008 Nov 29.
At present in the United Kingdom a number of different criteria are used to grade disease in carotid ultrasound investigations. One main cause of this has been the difference in the method of grading angiograms used in the NASCET and ECST large carotid surgery trials. It is desirable that all centres reporting carotid ultrasound investigations report to the same standard. This paper presents recommendations for the reporting of ultrasound investigations of the extra cranial arteries produced by a Joint Working Group formed between the Vascular Society of Great Britain and Ireland, and the Society for Vascular Technology of Great Britain and Ireland. The recommended criteria are based on the NASCET method of grading carotid bulb disease. Key recommendations include recording peak systolic velocity (PSV) and end-diastolic velocity (EDV) in both internal and distal common carotid arteries; measuring all velocities at a Doppler angle of 45-60 degrees; the use of internal carotid PSV of >1.25 ms(-1) and >2.3 ms(-1) and a Peak Systolic Velocity Ratio of >2 and >4 to indicate >50% and >70% stenosis respectively; and the use of the St Mary's Ratio to grade >50% stenoses in deciles. General recommendations are also given for the acquisition, interpretation and reporting of the data.
目前在英国，颈动脉超声检查中使用了多种不同的疾病分级标准。造成这种情况的一个主要原因是，北美症状性颈动脉内膜切除术试验（NASCET）和欧洲颈动脉外科试验（ECST）中使用的血管造影分级方法存在差异。所有报告颈动脉超声检查的中心都应按照同一标准进行报告，这一点很有必要。本文提出了由大不列颠及爱尔兰血管外科学会与大不列颠及爱尔兰血管技术学会联合成立的工作组所制定的关于颅外动脉超声检查报告的建议。推荐标准基于NASCET对颈动脉球部疾病的分级方法。主要建议包括记录颈内动脉和颈总动脉远端的收缩期峰值流速（PSV）和舒张末期流速（EDV）；在45 - 60度的多普勒角度下测量所有流速；使用颈内动脉PSV > 1.25 m·s⁻¹和> 2.3 m·s⁻¹以及收缩期峰值流速比> 2和> 4分别表示50%和70%以上的狭窄；使用圣玛丽比率对十分位数中50%以上的狭窄进行分级。还给出了关于数据采集、解读和报告的一般建议。
