Leahy A L, Grouden M C, Mc Bride K D, Ryan S R, Cullen P J, Bennett J, Moore D J, Shanik G D
Department of Vascular Surgery, St. James's Hospital, Dublin, Ireland.
Ann Vasc Surg. 1987 May;1(4):465-8. doi: 10.1016/S0890-5096(06)60733-4.
The value of Duplex scanning in 50 consecutive patients with symptomatic carotid stenosis was evaluated. Compared with contrast arteriography, the sensitivity of Duplex scanning, for a greater than 50% internal carotid diameter reduction, was 90% (66/73) with a specificity of 96% (26/27). The overall agreement between Duplex and contrast arteriography as measured by the Kappa value was K = 0.561. One of the 13 arteries felt to be occluded on Duplex scanning was radiologically found to be patent. Excluding the six normal and 13 occluded arteries, 81 carotid plaques were defined as either heterogeneous, suggestive of intraplaque hemorrhage or as homogeneous. Twenty-four of the 32 asymptomatic cerebral hemispheres were associated with ipsilateral homogeneous plaques, while 30 of the 49 symptomatic hemispheres had heterogeneous plaques in the ipsilateral carotid, (p less than 0.001). This study confirms the accuracy of duplex scanning in detecting internal carotid stenosis as well as in identifying plaques which are morphologically heterogeneous and more likely to be associated with ipsilateral cerebral hemispheric symptoms.
对连续50例有症状性颈动脉狭窄患者进行了双功扫描评估。与造影动脉造影相比，双功扫描对颈内动脉直径减少大于50%的敏感性为90%（66/73），特异性为96%（26/27）。通过Kappa值测量，双功扫描与造影动脉造影之间的总体一致性为K = 0.561。在双功扫描中被认为闭塞的13条动脉中有1条经放射学检查发现是通畅的。排除6条正常动脉和13条闭塞动脉后，81个颈动脉斑块被定义为不均匀的（提示斑块内出血）或均匀的。32个无症状脑半球中有24个与同侧均匀斑块相关，而49个有症状脑半球中有30个在同侧颈动脉有不均匀斑块（p<0.001）。本研究证实了双功扫描在检测颈内动脉狭窄以及识别形态学上不均匀且更可能与同侧脑半球症状相关的斑块方面的准确性。
