神经系统疾病中脑静脉流出的超声定量临界值：一项针对115名受试者的盲法研究。
A sonographic quantitative cutoff value of cerebral venous outflow in neurologic diseases: a blinded study of 115 subjects.
作者信息
Monti L, Menci E, Piu P, Leonini S, Arrigucci U, Bellini M, Zandonella A, Galluzzi P, Casasco A
机构信息
From the Unit of Neuroimaging and Neurointervention (L.M., E.M., S.L., U.A., M.B., A.Z., P.G.), Department of Neurological and Sensorial Sciences, Azienda Ospedaliera Universitaria Senese, Santa Maria alle Scotte General Hospital, Siena, Italy
From the Unit of Neuroimaging and Neurointervention (L.M., E.M., S.L., U.A., M.B., A.Z., P.G.), Department of Neurological and Sensorial Sciences, Azienda Ospedaliera Universitaria Senese, Santa Maria alle Scotte General Hospital, Siena, Italy.
出版信息
AJNR Am J Neuroradiol. 2014 Jul;35(7):1381-6. doi: 10.3174/ajnr.A3864. Epub 2014 Mar 7.
BACKGROUND AND PURPOSE
The autonomic nervous system maintains constant cerebral venous blood outflow in changing positions. Alterations in cerebral autoregulation can be revealed by postural changes at quantitative color Doppler sonography. The aim of this study was to reach an optimal cutoff value of the difference between the cerebral venous blood outflow in the supine and seated positions that can discriminate healthy controls from patients with multiple sclerosis and those with other neurologic diseases and to evaluate its specificity, sensitivity, and diagnostic accuracy.
MATERIALS AND METHODS
One hundred fifteen subjects (54 with MS, 31 healthy controls, 30 with other neurologic diseases) underwent a blinded quantitative color Doppler sonography evaluation of cerebral venous blood outflow in the supine and sitting positions. An optimal difference value between the supine and sitting positions of the cerebral venous blood outflow cutoff value was sought.
RESULTS
The difference value between supine and sitting positions of the cerebral venous blood outflow was ≤ 503.24 in 38/54 (70.37%) patients with MS, 9/31 (29.03%) healthy controls, and 13/30 (43.33%) subjects with other neurological diseases. A difference value between supine and sitting positions of the cerebral venous blood outflow at a 503.24 cutoff reached a sensitivity at 70.37%, a 70.96% specificity, a 80.85% positive predictive value, and a 57.89% negative predictive value; the quantitative color Doppler sonography parameters yielded significant differences. The difference value between supine and sitting positions of cerebral venous blood outflow ≤ 503.24 assessed the significant difference between MS versus other neurological diseases.
CONCLUSIONS
Alteration of cerebral venous blood outflow discriminated MS versus other neurologic diseases and MS versus healthy controls. The difference value between supine and sitting positions of cerebral venous blood outflow ≤ 503.24 was statistically associated with MS.
背景与目的
自主神经系统在体位变化时维持恒定的脑静脉血液流出。脑自动调节功能的改变可通过定量彩色多普勒超声检查时的体位变化来揭示。本研究的目的是得出仰卧位和坐位脑静脉血液流出差异的最佳临界值，以区分健康对照者与多发性硬化患者以及其他神经系统疾病患者，并评估其特异性、敏感性和诊断准确性。
材料与方法
115名受试者（54名多发性硬化患者、31名健康对照者、30名其他神经系统疾病患者）接受了仰卧位和坐位脑静脉血液流出的盲法定量彩色多普勒超声评估。寻找脑静脉血液流出临界值仰卧位和坐位之间的最佳差异值。
结果
54名多发性硬化患者中的38名（70.37%）、31名健康对照者中的9名（29.03%）以及30名其他神经系统疾病患者中的13名（43.33%）仰卧位和坐位脑静脉血液流出的差异值≤503.24。脑静脉血液流出仰卧位和坐位差异值在临界值为503.24时，敏感性为70.37%，特异性为70.96%，阳性预测值为80.85%，阴性预测值为57.89%；定量彩色多普勒超声参数有显著差异。脑静脉血液流出仰卧位和坐位差异值≤503.24评估了多发性硬化与其他神经系统疾病之间的显著差异。
结论
脑静脉血液流出的改变可区分多发性硬化与其他神经系统疾病以及多发性硬化与健康对照者。脑静脉血液流出仰卧位和坐位差异值≤503.24与多发性硬化在统计学上相关。
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