Steinke W, Kloetzsch C, Hennerici M
Department of Neurology, Heinrich Heine University of Düsseldorf, West Germany.
AJNR Am J Neuroradiol. 1990 Mar-Apr;11(2):259-66.
Carotid artery disease was assessed in 180 patients by means of color Doppler flow imaging. Color Doppler findings in 360 carotid arteries were compared with the results of standard Doppler sonography, and color Doppler findings in 60 bifurcations were compared with the results of intraarterial angiography. The sensitivity of color Doppler for the detection of carotid disease was 100% when compared with angiography. The accuracy of color Doppler in classifying minor (40-60%), moderate (61-80%), and severe (81-90%) stenosis ranged from 91.3% to 97.8% vs standard Doppler sonography, and from 91.7% to 95.8% vs angiography. Whereas all occlusions were identified correctly by both color Doppler and angiography, four pseudoocclusions of the carotid artery were misdiagnosed as occluded. Characteristic features providing reliable criteria of the degree of stenosis are (1) intensity, extent, and duration of color fading; (2) postprocessed systolic peak frequency; (3) plaque extent on serial sonograms; and (4) poststenotic flow patterns. Display of hemodynamic disturbances induced by less pronounced plaques showed highly variable patterns that could not be anticipated from the plaque morphology alone. Thus, color Doppler preserves the advantages of standard Doppler and duplex sonography but provides additional information about otherwise anechoic necrotic and thrombotic material that often causes cerebral embolisms. With atherogenesis, repair mechanisms may be sustained or progression be stopped by reducing the risk factors and instituting medical treatment; thus, the application of this noninvasive technique is important.
通过彩色多普勒血流成像对180例患者的颈动脉疾病进行了评估。将360条颈动脉的彩色多普勒检查结果与标准多普勒超声检查结果进行比较，并将60个分叉处的彩色多普勒检查结果与动脉内血管造影结果进行比较。与血管造影相比，彩色多普勒检测颈动脉疾病的敏感性为100%。彩色多普勒对轻度（40 - 60%）、中度（61 - 80%）和重度（81 - 90%）狭窄进行分类的准确性，与标准多普勒超声检查相比，范围为91.3%至97.8%，与血管造影相比，范围为91.7%至95.8%。虽然彩色多普勒和血管造影都能正确识别所有闭塞情况，但有4例假性颈动脉闭塞被误诊为闭塞。提供可靠狭窄程度标准的特征包括：（1）彩色消退的强度、范围和持续时间；（2）后处理的收缩期峰值频率；（3）连续超声图像上的斑块范围；（4）狭窄后血流模式。不太明显斑块引起的血流动力学紊乱表现出高度可变的模式，仅从斑块形态无法预测。因此，彩色多普勒保留了标准多普勒和双功超声的优点，但提供了关于通常导致脑栓塞的无回声坏死和血栓物质的额外信息。随着动脉粥样硬化的发展，通过降低危险因素和进行医学治疗，修复机制可能得以维持或进展停止；因此，应用这种非侵入性技术很重要。
