Glover J L, Bendick P J, Jackson V P, Becker G J, Dilley R S, Holden R W
Arch Surg. 1984 Jun;119(6):664-9. doi: 10.1001/archsurg.1984.01390180032006.
We prospectively compared duplex ultrasonography with digital subtraction angiography (DSA) and conventional angiography in the evaluation of carotid atherosclerosis by studying 494 arteries. Arteries were graded independently as normal, mildly stenotic, moderately stenotic, severely stenotic, or occluded. There was absolute agreement between duplex ultrasonography and DSA as to disease severity in 296 (68%) of 434 vessels, good correlation in an additional 119 vessels (28%), and poor correlation in 19 vessels (4%). When duplex studies were compared with conventional angiograms, the correlations were similar: absolute for 60 (71%) of 85 vessels, good for 17 (20%) of 85 vessels, and poor for eight (9%) of 85 vessels. With conventional angiography as the standard, duplex studies tended to overestimate the severity of disease in 64% of vessels and underestimate it in 36%, v 28% and 72%, respectively, for DSA. We concluded that duplex ultrasonography is as accurate as DSA in assessing carotid bifurcation atherosclerosis. The tendency of DSA to underestimate disease severity may lead to diagnostic errors in patients with nonobstructive plaques.
我们通过研究494条动脉，前瞻性地比较了双功超声与数字减影血管造影（DSA）及传统血管造影在评估颈动脉粥样硬化方面的效果。动脉被独立分级为正常、轻度狭窄、中度狭窄、重度狭窄或闭塞。在434条血管中，双功超声与DSA在疾病严重程度方面完全一致的有296条（68%），另有119条血管（28%）相关性良好，19条血管（4%）相关性较差。当将双功超声检查结果与传统血管造影结果进行比较时，相关性类似：85条血管中有60条（71%）完全一致，85条血管中有17条（20%）相关性良好，85条血管中有8条（9%）相关性较差。以传统血管造影为标准，双功超声检查在64%的血管中倾向于高估疾病严重程度，在36%的血管中倾向于低估疾病严重程度，而对于DSA，这两个比例分别为28%和72%。我们得出结论，双功超声在评估颈动脉分叉处动脉粥样硬化方面与DSA一样准确。DSA有低估疾病严重程度的倾向，这可能会导致对有非阻塞性斑块的患者出现诊断错误。
