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[彩色编码双功超声在内颈动脉闭塞前狭窄中的应用]

[Color-coded duplex ultrasound in pre-occlusive stenoses of the internal carotid artery].

作者信息

Hetzel A, Eckenweber B, Trummer B, Wernz M, von Reutern G M

机构信息

Neurologische Universitätsklinik, Klinikum der Albert-Ludwigs-universitäts Freiburg.

出版信息

Ultraschall Med. 1993 Oct;14(5):240-6. doi: 10.1055/s-2007-1005254.

Abstract

In a prospective study the results of 238 consecutive ultrasound examinations of the carotid artery were correlated with angiography to test the reliability of colour coded duplex sonography in preocclusive carotid artery disease. This series was compared with a series of 611 vessels with angiographically controlled conventional duplex sonography. In 61 resp. 84 cases stenoses > or = 90% or occlusions of the internal carotid artery were found. The reliability of colour coded duplex sonography for the diagnosis of > or = 90% stenoses was extremely high (sensitivity and specificity 98%), as well as in preocclusive, > 95% stenoses (100% and 98%), and for the diagnosis of occlusion, after exclusion of angiographic false positive diagnosis of occlusion (95% and 99%). Statistically colour coded flow imaging failed to increase significantly the high diagnostic sensitivity or specificity of conventional duplex sonography, especially in preocclusive carotid artery disease. However, the remarkable increase in frequency of the diagnosis preocclusive stenosis with the introduction of colour coded Duplex Sonography probably reflects a higher sensitivity of this method. In addition the direct comparison of both ultrasound techniques showed a better image of the vessel wall abnormalities and the residual lumen with colour coded duplex sonography.

摘要

在一项前瞻性研究中,对238例连续的颈动脉超声检查结果与血管造影进行相关性分析,以检验彩色编码双功超声在颈动脉闭塞性疾病中的可靠性。该系列与611例经血管造影对照的传统双功超声检查的血管系列进行比较。分别在61例和84例中发现颈内动脉狭窄≥90%或闭塞。彩色编码双功超声诊断≥90%狭窄的可靠性极高(敏感性和特异性均为98%),在闭塞前期、>95%狭窄时也是如此(分别为100%和98%),在排除血管造影假阳性闭塞诊断后,诊断闭塞的可靠性也很高(分别为95%和99%)。从统计学角度看,彩色编码血流成像未能显著提高传统双功超声的高诊断敏感性或特异性,尤其是在颈动脉闭塞性疾病中。然而,引入彩色编码双功超声后,闭塞前期狭窄诊断频率的显著增加可能反映了该方法更高的敏感性。此外,两种超声技术的直接比较显示,彩色编码双功超声对血管壁异常和残余管腔的成像更好。

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