Chambers B R, Norris J W
Neurology. 1985 May;35(5):742-5. doi: 10.1212/wnl.35.5.742.
The value of neck bruits as indicators of underlying carotid artery disease was assessed by correlating the results of carotid Doppler examination with auscultation in 336 patients with asymptomatic bruits. Also, the separate findings of auscultation by two physicians were compared for agreement in the quality and location of the bruits. Levels of agreement between the physicians in the clinical examination were acceptable for the presence and site of the neck bruits, but were unacceptable for the intensity, pitch, and duration. Unilateral bruits in the upper neck indicated underlying internal carotid artery (ICA) stenosis detectable by carotid Doppler (greater than 35% stenosis) in 61%, whereas only 11% of patients with bruits localized to the supraclavicular area had ICA stenosis. "Silent" contralateral ICA stenosis was detected by Doppler in 28% of patients with unilateral cervical bruits. Bilateral cervical bruits were the most powerful predictors (76%) of underlying ICA stenosis detectable by Doppler. Neck bruits are valuable indicators of underlying carotid artery disease, but Doppler ultrasound examination adds significantly to clinical accuracy.
通过对336例无症状颈部杂音患者的颈动脉多普勒检查结果与听诊结果进行相关性分析，评估颈部杂音作为潜在颈动脉疾病指标的价值。此外，还比较了两位医生听诊的单独结果，以确定在杂音质量和位置方面的一致性。医生在临床检查中对颈部杂音的存在和部位的一致性水平是可以接受的，但在强度、音调及持续时间方面的一致性不可接受。上颈部单侧杂音表明，经颈动脉多普勒检查可检测到潜在的颈内动脉（ICA）狭窄（狭窄程度大于35%）的患者占61%，而杂音局限于锁骨上区域的患者中只有11%存在ICA狭窄。在单侧颈部杂音患者中，28%的患者经多普勒检查发现对侧ICA存在“无症状性”狭窄。双侧颈部杂音是经多普勒检查可检测到潜在ICA狭窄的最强有力预测指标（76%）。颈部杂音是潜在颈动脉疾病的重要指标，但多普勒超声检查能显著提高临床诊断的准确性。
