Leng G C, Whyman M R, Donnan P T, Ruckley C V, Gillespie I, Fowkes F G, Allan P L
Department of Public Health Sciences, University of Edinburgh, United Kingdom.
J Vasc Surg. 1993 Mar;17(3):510-7.
The aim of this study was to determine the accuracy of Doppler waveform characteristics in grading femoropopliteal stenoses and to determine the interobserver and intraobserver reproducibility of measuring the same waveform characteristics.
Thirty patients with isolated areas of stenosis found by arteriography were evaluated by color duplex sonography. Each patient underwent scanning by two observers on two separate occasions. Each observer was blind to the other's results. Doppler spectra were recorded in areas where color change suggested the highest velocity and also at the nearest normal proximal area. Peak systolic velocity, spectral broadening, and waveform configuration were measured at each site.
An increase in peak systolic velocity of more than 200% accurately predicted a 50% or greater reduction in luminal diameter on angiography (70% sensitivity, 96% specificity). The presence of spectral broadening and an abnormal waveform shape were found to correlate poorly with the degree of stenosis. Analysis of variance showed no significant difference between observers in velocity measurements (p = 0.78).
We conclude that although stenoses of greater than 50% can be distinguished from minor stenoses, more precise definition of the degree of narrowing is unlikely. The good repeatability of the velocity ratio makes it an excellent tool for monitoring major changes in the progression of disease.
本研究旨在确定多普勒波形特征在股腘动脉狭窄分级中的准确性，并确定测量相同波形特征时观察者间和观察者内的可重复性。
对30例经血管造影发现存在孤立狭窄区域的患者进行彩色多普勒超声检查。每位患者由两名观察者在两个不同时间进行扫描。每位观察者对对方的结果均不知情。在颜色变化提示流速最高的区域以及最近的正常近端区域记录多普勒频谱。在每个部位测量收缩期峰值流速、频谱增宽和波形形态。
收缩期峰值流速增加超过200%准确预测血管造影显示管腔直径减少50%或更多（敏感性70%，特异性96%）。发现频谱增宽和异常波形形态与狭窄程度的相关性较差。方差分析显示观察者间在流速测量方面无显著差异（p = 0.78）。
我们得出结论，虽然大于50%的狭窄可与轻度狭窄相区分，但不太可能对狭窄程度进行更精确的定义。流速比的良好重复性使其成为监测疾病进展主要变化的优秀工具。
