Keven Ayşe, Durmaz Mehmet Sedat
Akdeniz University School of Medicine, Department of Radiology, Antalya, Turkey.
Konya Health Sciences University Teaching and Research Hospital, Department of Radiology, Konya, Turkey.
J Ultrason. 2017 Dec;17(71):235-240. doi: 10.15557/JoU.2017.0034. Epub 2017 Dec 29.
Peripheral arterial disease is an atherosclerotic disease characterized by an increase in morbidity and mortality. For these reasons early diagnosis of peripheral arterial disease is important. Ankle-brachial systolic pressure index measurement is frequently used in screening studies. Evaluating waveforms of distal lower extremities with Doppler ultrasound can be used as a screening program and provides more accurate information on peripheral arterial disease.
We investigate the prevalence of peripheral arterial disease, compare the efficacy of Doppler ultrasound evaluation of distal lower extremity waveforms and ankle-brachial systolic pressure index measurement in screening programs, and discuss the importance of early diagnosis of asymptomatic cases.
A total of 457 patients over the age of 65 (between 65 and 94, mean age: 71.4) including 270 males and 187 females were examined with Doppler ultrasound, had ankle-brachial systolic pressure index measurement taken and were screened for peripheral arterial disease. The correlation between Doppler ultrasound findings and ankle-brachial systolic pressure index was examined.
According to the Doppler ultrasound findings, in the aortoiliac ( = 0.648) and femoropopliteal ( = 0.564) area, there is a medium level of correlation between severe stenosis and occlusions and a low ankle-brachial systolic pressure index value, and a low level of correlation between such abnormalities in the tibioperoneal region ( = 0.116) and a low ankle-brachial systolic pressure index value. Therefore, while the sensitivity of ankle-brachial systolic pressure index increases in proximal stenosis, it decreases in distal stenosis.
Despite the fact that ankle-brachial systolic pressure index is a diagnostic test commonly used in screening studies, evaluation of distal arteries by means of Doppler ultrasound provides more accurate information in terms of the identification of peripheral arterial disease.
外周动脉疾病是一种以发病率和死亡率增加为特征的动脉粥样硬化疾病。基于这些原因，外周动脉疾病的早期诊断很重要。踝臂收缩压指数测量在筛查研究中经常被使用。用多普勒超声评估下肢远端的波形可作为一种筛查程序，并能提供关于外周动脉疾病更准确的信息。
我们调查外周动脉疾病的患病率，比较在筛查程序中用多普勒超声评估下肢远端波形和踝臂收缩压指数测量的效果，并讨论无症状病例早期诊断的重要性。
对457名65岁以上（年龄在65至94岁之间，平均年龄：71.4岁）的患者进行了检查，其中包括270名男性和187名女性，用多普勒超声进行检查，测量踝臂收缩压指数，并筛查外周动脉疾病。检查了多普勒超声检查结果与踝臂收缩压指数之间的相关性。
根据多普勒超声检查结果，在主髂动脉（=0.648）和股腘动脉（=0.564）区域，严重狭窄和闭塞与低踝臂收缩压指数值之间存在中等程度的相关性，而在胫腓区域此类异常（=0.116）与低踝臂收缩压指数值之间存在低程度的相关性。因此，虽然踝臂收缩压指数在近端狭窄时敏感性增加，但在远端狭窄时敏感性降低。
尽管踝臂收缩压指数是筛查研究中常用的诊断测试，但通过多普勒超声评估远端动脉在识别外周动脉疾病方面能提供更准确的信息。
