Cebul R D, Ginsberg M D
Ann Intern Med. 1982 Dec;97(6):867-72. doi: 10.7326/0003-4819-97-6-867.
Indirect noninvasive neurovascular tests provide information on hemodynamic changes cephalad to the carotid bifurcation, whereas direct tests measure anatomic or physiologic changes at the bifurcation itself. Batteries of tests are often done and should combine both indirect and direct methods. Results with two ultrasonic techniques and digital subtraction intravenous angiography suggest a larger role for these methods. Carotid arteriography is the definitive procedure for evaluating the carotid artery, although it should only be done when carotid endarterectomy is contemplated. The relative risks and benefits of other diagnostic and therapeutic management strategies should guide the decision to do noninvasive neurovascular tests, or to proceed directly to arteriography.
间接无创性神经血管检查可提供有关颈动脉分叉上方血流动力学变化的信息，而直接检查则测量分叉处本身的解剖学或生理学变化。通常会进行一系列检查，且应将间接和直接方法结合起来。两种超声技术和数字减影静脉血管造影的结果表明这些方法具有更大的作用。颈动脉造影是评估颈动脉的确定性检查方法，不过仅在考虑进行颈动脉内膜切除术时才应进行。其他诊断和治疗管理策略的相对风险和益处应指导决定是否进行无创性神经血管检查或直接进行血管造影。
