颈动脉手术患者中双功超声与血管造影的准确性比较
Accuracy of duplex versus angiography in patients undergoing carotid surgery.
作者信息
Boyle M J, Wolinski A P, Grimley R P
机构信息
Department of Vascular Surgery, Wordsley Hospital, Stourbridge, West Midlands, UK.
出版信息
J R Soc Med. 1995 Jan;88(1):20-3.
The operative findings of 23 carotid arteries were compared with pre-operative duplex scans and angiography. Both duplex and angiography had a high degree of accuracy in detecting haemodynamically significant lesions of 50-99% (88 and 92%, respectively). Their accuracy, however, in correctly predicting the grade of stenosis was significantly lower; 30 and 48%, respectively (P < 0.001). They each exhibited an accuracy of 70% and 78%, respectively, in the detection of ulceration. Overall, both duplex and angiography displayed an accuracy of 87% in indicating the proper management course. The combination of both investigations increased this accuracy to 94.6%. In severely stenotic lesions, duplex to rule out occlusion was not reliable. On statistical analysis, there was no difference between duplex and angiography in predicting haemodynamically significant lesions of 50-99%, estimating the grade of stenosis, the detection of ulceration, or indicating the proper management course. In most situations, duplex alone equalled the accuracy of angiography in the pre-operative assessment of patients for carotid surgery. For stenotic lesions of > 90%, however, we recommend supplemental angiography to rule out occlusion.
将23条颈动脉的手术结果与术前双功超声扫描和血管造影结果进行了比较。双功超声扫描和血管造影在检测血流动力学显著病变方面的准确率都很高，分别为50 - 99%（分别为88%和92%）。然而，它们在正确预测狭窄程度方面的准确率显著较低，分别为30%和48%（P < 0.001）。它们在检测溃疡方面的准确率分别为70%和78%。总体而言，双功超声扫描和血管造影在指示正确的治疗方案方面的准确率均为87%。两种检查方法相结合可将该准确率提高到94.6%。在严重狭窄病变中，双功超声扫描排除闭塞的可靠性不高。经统计学分析，双功超声扫描和血管造影在预测50 - 99%的血流动力学显著病变、估计狭窄程度、检测溃疡或指示正确的治疗方案方面没有差异。在大多数情况下，在对患者进行颈动脉手术的术前评估中，单独使用双功超声扫描的准确率与血管造影相当。然而，对于狭窄程度> 90%的病变，我们建议进行补充血管造影以排除闭塞。
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