Zorzon M, Carraro N, Pasqua M, Monti F, Masé G
Clinica Neurologica, Università, Trieste.
Riv Neurol. 1987 Nov-Dec;57(6):342-5.
The results of the carotid artery Doppler ultrasound examination were compared with those of digital subtraction angiography in 256 patients (187 men and 69 women) with carotid bruit. The hemodynamically significant stenoses of more than 50% and the occlusions in the 512 carotid arteries examined were considered and the sensibility, the specificity and the overall accuracy of the Doppler ultrasound examination were calculated. When a carotid stenosis was diagnosed a sensibility of 97%, a specificity of 95% and an overall accuracy of 96% was found, while, for the diagnosis of carotid occlusion, the extimated sensibility, specificity and overall accuracy was 95%. Therefore, the ability to recognize a normal or an occluded carotid artery was of 95% (we found 125 out of 131 normal carotid arteries and 52 out of 55 occluded carotid arteries), whereas a stenotic carotid artery was identified in the 97% of cases (316 out of 326 stenotic carotid arteries). When both diagnoses of carotid stenosis and carotid occlusion were considered together, the extimated sensibility, specificity and overall accuracy were of 98%, 95% and 98% respectively. So the probability of misdiagnosing was of 2% (we made 10 wrong diagnoses out of 512 carotid arteries examined).
对256例(187例男性和69例女性)有颈动脉杂音的患者进行了颈动脉多普勒超声检查,并与数字减影血管造影结果进行了比较。考虑了所检查的512条颈动脉中血流动力学意义上大于50%的显著狭窄和闭塞情况,并计算了多普勒超声检查的敏感性、特异性和总体准确性。诊断颈动脉狭窄时,敏感性为97%,特异性为95%,总体准确性为96%;而对于颈动脉闭塞的诊断,估计的敏感性、特异性和总体准确性为95%。因此,识别正常或闭塞颈动脉的能力为95%(我们在131条正常颈动脉中识别出125条,在55条闭塞颈动脉中识别出52条),而在97%的病例中识别出狭窄的颈动脉(326条狭窄颈动脉中识别出316条)。当同时考虑颈动脉狭窄和颈动脉闭塞的诊断时,估计的敏感性、特异性和总体准确性分别为98%、95%和98%。所以误诊的概率为2%(在所检查的512条颈动脉中我们做出了10次错误诊断)。