预测颈内动脉狭窄程度大于或等于50%、60%、70%和80%的最佳收缩期峰值速度阈值
Optimal Peak Systolic Velocity Thresholds for Predicting Internal Carotid Artery Stenosis Greater than or Equal to 50%, 60%, 70%, and 80%.
作者信息
Tokunaga Keisuke, Koga Masatoshi, Yoshimura Sohei, Arihiro Shoji, Suzuki Rieko, Nagatsuka Kazuyuki, Toyoda Kazunori
机构信息
Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
Division of Stroke Care Unit, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
出版信息
J Stroke Cerebrovasc Dis. 2016 Apr;25(4):921-6. doi: 10.1016/j.jstrokecerebrovasdis.2015.12.021. Epub 2016 Feb 2.
BACKGROUND
We aimed to determine the optimal peak systolic velocity (PSV) thresholds for predicting ≥50%, ≥60%, ≥70%, and ≥80% internal carotid artery (ICA) stenosis.
METHODS
Patients who underwent both carotid ultrasonography and cerebral angiography during hospitalization were consecutively and retrospectively enrolled. The degree of ICA stenosis was calculated using the North American Symptomatic Carotid Endarterectomy Trial method on cerebral angiography. The optimal PSV thresholds for predicting ≥50%, ≥60%, ≥70%, and ≥80% ICA stenosis were determined using receiver operating characteristic curves and the Youden index.
RESULTS
A total of 127 ICAs were analyzed. The optimal PSV thresholds for predicting ≥50%, ≥60%, ≥70%, and ≥80% ICA stenosis were 130 cm/s (sensitivity, 95%; specificity, 85%; positive predictive value [PPV], 75%; negative predictive value [NPV], 97%; overall accuracy, 88%), 160 cm/s (sensitivity, 91%; specificity, 94%; PPV, 83%; NPV, 97%; overall accuracy, 93%), 200 cm/s (sensitivity, 96%; specificity, 95%; PPV, 83%; NPV, 99%; overall accuracy, 95%), and 270 cm/s (sensitivity, 89%; specificity, 94%; PPV, 74%; NPV, 98%; overall accuracy, 94%), respectively.
CONCLUSIONS
The optimal PSV thresholds for predicting ≥50%, ≥60%, ≥70%, and ≥80% ICA stenosis were 130 cm/s, 160 cm/s, 200 cm/s, and 270 cm/s, respectively. All of them had high diagnostic accuracies.
背景
我们旨在确定预测颈内动脉（ICA）狭窄≥50%、≥60%、≥70%和≥80%的最佳收缩期峰值流速（PSV）阈值。
方法
连续且回顾性纳入住院期间同时接受颈动脉超声检查和脑血管造影的患者。使用北美症状性颈动脉内膜切除术试验方法在脑血管造影上计算ICA狭窄程度。使用受试者工作特征曲线和尤登指数确定预测ICA狭窄≥50%、≥60%、≥70%和≥80%的最佳PSV阈值。
结果
共分析了127条ICA。预测ICA狭窄≥50%、≥60%、≥70%和≥80%的最佳PSV阈值分别为130 cm/s（敏感性95%；特异性85%；阳性预测值[PPV] 75%；阴性预测值[NPV] 97%；总体准确率88%）、160 cm/s（敏感性91%；特异性94%；PPV 83%；NPV 97%；总体准确率93%）、200 cm/s（敏感性96%；特异性95%；PPV 83%；NPV 99%；总体准确率95%）和270 cm/s（敏感性89%；特异性94%；PPV 74%；NPV 98%；总体准确率94%）。
结论
预测ICA狭窄≥50%、≥60%、≥70%和≥80%的最佳PSV阈值分别为130 cm/s、160 cm/s、200 cm/s和270 cm/s。它们均具有较高的诊断准确性。
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