加速时间比值在诊断颈内动脉起始部狭窄中的应用价值

Usefulness of acceleration time ratio in diagnosis of internal carotid artery origin stenosis.

作者信息

Nishihira Takahito, Takekawa Hidehiro, Suzuki Keisuke, Suzuki Ayano, Tsukahara Yuka, Iizuka Kentaro, Igarashi Haruki, Iwasaki Akio, Okamura Madoka, Hirata Koichi

机构信息

Stroke Division, Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan.

Center of Medical Ultrasonics, Dokkyo Medical University, Tochigi, Japan.

出版信息

J Med Ultrason (2001). 2018 Jul;45(3):493-500. doi: 10.1007/s10396-018-0863-4. Epub 2018 Jan 31.

DOI:10.1007/s10396-018-0863-4

PMID:29388010

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6028849/

Abstract

PURPOSE

The acceleration time (AcT) ratio of the internal carotid artery (ICA) is increased in ICA stenosis. However, there are few reports that have directly compared the AcT ratio to digital subtraction angiography (DSA) findings.

METHODS

We evaluated 177 vessels with DSA and carotid artery ultrasonography. The AcT ratio was calculated as AcT of the ICA (ICA-AcT)/AcT of the ipsilateral common carotid artery (CCA). We evaluated the correlation of DSA-NASCET stenosis with the origin of the ICA or the peak systolic velocity (ICApsv) in the stenotic region, ICApsv/peak systolic velocity of the CCA (CCApsv), ICA-AcT, and AcT ratio. Sensitivity and specificity for stenosis ≥ 70% were calculated based on the ICApsv, ICApsv/CCApsv, ICA-AcT, and AcT ratio.

RESULTS

Using NASCET criteria, 34 vessels had 70% or greater stenosis. DSA-NASCET showed a significant positive correlation with ICApsv, ICApsv/CCApsv, ICA-AcT, and AcT ratio (p < 0.0001). When the cut-off value for ICApsv was set at 176 cm/s, ICApsv/CCApsv at 2.42, ICA-AcT at 0.095 s, and the AcT ratio at 1.35, the sensitivity was 97.1, 97.1, 82.4, and 97.1%, and the specificity was 94.4, 91.0, 83.2, and 83.2%, for DSA-NASCET ≥ 70%, respectively.

CONCLUSION

The AcT ratio is a beneficial parameter for evaluating ICA stenosis as well as ICApsv and ICApsv/CCApsv.

摘要

目的

颈内动脉（ICA）狭窄时，颈内动脉加速时间（AcT）比值会升高。然而，很少有报告直接将AcT比值与数字减影血管造影（DSA）结果进行比较。

方法

我们对177条血管进行了DSA和颈动脉超声检查。AcT比值计算为ICA的AcT（ICA-AcT）/同侧颈总动脉（CCA）的AcT。我们评估了DSA-NASCET狭窄与ICA起源或狭窄区域的收缩期峰值速度（ICApsv）、ICApsv/CCA的收缩期峰值速度（CCApsv）、ICA-AcT和AcT比值之间的相关性。基于ICApsv、ICApsv/CCApsv、ICA-AcT和AcT比值计算狭窄≥70%的敏感性和特异性。

结果

采用NASCET标准，34条血管存在70%或更高程度的狭窄。DSA-NASCET与ICApsv、ICApsv/CCApsv、ICA-AcT和AcT比值呈显著正相关（p< 0.0001）。当ICApsv的截断值设定为176 cm/s、ICApsv/CCApsv设定为2.42、ICA-AcT设定为0.095 s以及AcT比值设定为1.35时，对于DSA-NASCET≥70%，敏感性分别为97.1%、97.1%、82.4%和97.1%，特异性分别为94.4%、91.0%、83.2%和83.2%。