Ajduk Marko, Bulimbasić Stela, Pavić Ladislav, Sarlija Mirko, Patrlj Leonardo, Brkljacić Boris, Pavić Predrag, Cikara Igor, Ivanac Gordana
University of Zagreb, Dubrava University Hospital, Department of Vascular Surgery, Zagreb, Croatia.
Coll Antropol. 2013 Mar;37(1):213-9.
This study compared sensitivity and specificity of multidetector-row computed tomography and duplex Doppler ultrasonography in detecting atherosclerotic carotid plaques complicated with intraplaque hemorrhage. Carotid plaques from 50 patients operated for carotid artery stenosis were analyzed. Carotid endarterectomy was performed within one week of diagnostic evaluation. Results of multidetector-row computed tomography and duplex Doppler ultrasonography diagnostic evaluation were compared with results of histological analysis of the same plaque areas. American Heart Association classification of atherosclerotic plaques was applied for histological classification. Median tissue density of carotid plaques complicated with intraplaque hemorrhage was 14.7 Hounsfield units. Median tissue density of noncalcified segments of uncomplicated plaques was 54.3 Hounsfield units (p = 0.00003). The highest tissue density observed for complicated plaques was 31.8 Hounsfield units. Multidetector-row computed tomography detected plaques complicated with hemorrhage with sensitivity of 100% and specificity of 70.4%, with tissue density of 33.8 Hounsfield units as a threshold value. Duplex Doppler ultrasonography plaque analysis based on visual in-line classification showed sensitivity of 21.7% and specificity of 89.6% in detecting plaques complicated with intraplaque hemorrhage. Multidetector-row computed tomography showed a very high level of sensitivity and a moderate level of specificity in detecting atherosclerotic carotid plaques complicated with hemorrhage. Duplex Doppler ultrasonography plaque analysis based on visual in-line classification showed a low level of sensitivity and a moderate-high level of specificity in detecting atherosclerotic carotid plaques complicated with hemorrhage.
本研究比较了多排螺旋计算机断层扫描（MDCT）和双功多普勒超声检查在检测合并斑块内出血的动脉粥样硬化性颈动脉斑块方面的敏感性和特异性。分析了50例因颈动脉狭窄接受手术治疗患者的颈动脉斑块。在诊断评估后一周内进行颈动脉内膜切除术。将MDCT和双功多普勒超声检查的诊断评估结果与同一斑块区域的组织学分析结果进行比较。应用美国心脏协会的动脉粥样硬化斑块分类进行组织学分类。合并斑块内出血的颈动脉斑块的组织密度中位数为14.7亨氏单位。未合并斑块内出血的斑块非钙化段的组织密度中位数为54.3亨氏单位（p = 0.00003）。合并斑块内出血的斑块观察到的最高组织密度为31.8亨氏单位。MDCT检测合并出血的斑块，以33.8亨氏单位的组织密度为阈值时，敏感性为100%，特异性为70.4%。基于视觉在线分类的双功多普勒超声斑块分析在检测合并斑块内出血的斑块时，敏感性为21.7%，特异性为89.6%。MDCT在检测合并出血的动脉粥样硬化性颈动脉斑块方面显示出非常高的敏感性和中等水平的特异性。基于视觉在线分类的双功多普勒超声斑块分析在检测合并出血的动脉粥样硬化性颈动脉斑块方面显示出低水平的敏感性和中等偏高水平的特异性。
