Bornstein N M, Beloev Z G, Norris J W
Department of Neurosciences, Sunnybrook Medical Centre, University of Toronto, Ontario, Canada.
Ann Surg. 1988 Mar;207(3):315-7. doi: 10.1097/00000658-198803000-00015.
Duplex scanning has been advocated as an acceptable alternative to angiography in the preoperative evaluation of carotid artery stenosis. To evaluate the accuracy of carotid Doppler in differentiating severe carotid stenosis from occlusion, we compared the results of angiography with duplex scanning in 124 carotid arteries (62 patients) and with continuous-wave Doppler in 662 carotid arteries (331 patients). The specificity was 95-99%, sensitivity was 86-96%, and accuracy was 95-98%. Duplex scanning wrongly identified occlusion in four arteries and failed to detect occlusion in one artery. In making decisions prior to carotid endarterectomy, even infrequent errors are unacceptable. We recommend angiography of all surgical candidates with apparent severe stenosis when the internal carotid artery cannot be clearly identified on duplex, or to distinguish apparent occlusion from undetectably low blood flow.
在颈动脉狭窄的术前评估中，双功扫描已被视为一种可接受的血管造影替代方法。为了评估颈动脉多普勒在鉴别严重颈动脉狭窄与闭塞方面的准确性，我们将124条颈动脉（62例患者）的血管造影结果与双功扫描结果进行了比较，并将662条颈动脉（331例患者）的血管造影结果与连续波多普勒结果进行了比较。特异性为95 - 99%，敏感性为86 - 96%，准确性为95 - 98%。双功扫描在四条动脉中错误地识别为闭塞，在一条动脉中未能检测到闭塞。在进行颈动脉内膜切除术之前做出决策时，即使是很少发生的错误也是不可接受的。我们建议，当在双功扫描中无法清晰识别颈内动脉时，或者为了区分明显的闭塞与难以检测到的低血流时，对所有明显严重狭窄的手术候选者进行血管造影。
