Sawchuk A P, Flanigan D P, Tober J C, Eton D, Schwarcz T H, Eldrup-Jorgensen J, Meyer J P, Durham J R, Schuler J J
Department of Surgery, University of Illinois College of Medicine, Chicago.
J Vasc Surg. 1990 Aug;12(2):158-67. doi: 10.1067/mva.1990.20842.
Accurate hemodynamic evaluation of the aortoiliac system for the purpose of determining the need for an inflow procedure currently requires invasive pressure measurements. This study was undertaken to evaluate a noninvasive technique with the aortofemoral transfer function. Twenty-eight human aortoiliac segments were studied with intraarterial pressure measurements, with and without papaverine injection, and by calculation of the Doppler-derived mean power frequency index obtained by digital signal processing of aortic and femoral spectra. The procedure is menu driven and can be performed by any duplex ultrasound technologist. This technique involves recording 20 aortic and 20 femoral Doppler signals, requiring less than 1 minute of data acquisition time. Intraarterial pressure measurements were used to classify arteries into the three following groups: (1) normal arteries, (2) arteries with subcritical stenoses, and (3) arteries with critical stenoses. The mean power frequency index of group 1 arteries (n = 7) was 0.63 +/- 0.04, of group 2 arteries (n = 6) was 0.46 +/- 0.02, and of group 3 arteries (n = 15) was 0.21 +/- 0.05. These mean power frequency index values were significantly different by analysis of variance (ANOVA) (p less than 0.0001). Each group could be differentiated from the other groups with a sensitivity of 0.83 to 1.00, a specificity of 1.00, and an accuracy of 0.92 to 1.00 compared to intraarterial pressure measurements, including papaverine testing. Measurement of the mean power frequency index is a rapid, noninvasive technique that diagnoses and quantifies aortoiliac stenoses with an accuracy similar to intraarterial pressure measurements.
目前，为了确定是否需要进行流入道手术，对主髂动脉系统进行准确的血流动力学评估需要进行有创压力测量。本研究旨在评估一种利用主股动脉传递函数的无创技术。对28个人类主髂动脉节段进行了研究，测量了动脉内压力（注射罂粟碱前后），并通过对主动脉和股动脉频谱进行数字信号处理计算出多普勒衍生的平均功率频率指数。该程序由菜单驱动，任何一位双功超声技术人员都可以操作。该技术需要记录20个主动脉和20个股动脉的多普勒信号，数据采集时间不到1分钟。动脉内压力测量用于将动脉分为以下三组：（1）正常动脉，（2）亚临界狭窄动脉，（3）临界狭窄动脉。第1组动脉（n = 7）的平均功率频率指数为0.63±0.04，第2组动脉（n = 6）为0.46±0.02，第3组动脉（n = 15）为0.21±0.05。通过方差分析（ANOVA），这些平均功率频率指数值有显著差异（p<0.0001）。与动脉内压力测量（包括罂粟碱试验）相比，每组与其他组之间的区分灵敏度为0.83至1.00，特异性为1.00，准确性为0.92至1.00。测量平均功率频率指数是一种快速、无创的技术，诊断和量化主髂动脉狭窄的准确性与动脉内压力测量相似。
