动脉闭塞性疾病的非侵入性定位：节段性多普勒压力与动脉双功超声成像的比较

Noninvasive localization of arterial occlusive disease: a comparison of segmental Doppler pressures and arterial duplex mapping.

作者信息

Moneta G L, Yeager R A, Lee R W, Porter J M

机构信息

Department of Surgery, Oregon Health Sciences University, Portland 97201.

出版信息

J Vasc Surg. 1993 Mar;17(3):578-82. doi: 10.1067/mva.1993.39247.

DOI:10.1067/mva.1993.39247

PMID:8445755

Abstract

PURPOSE

The purpose of this study was to compare the abilities of arterial duplex mapping and segmental Doppler pressures to noninvasively localize hemodynamically significant lower extremity arterial occlusive disease.

METHODS

After angiographic controls were instituted, arterial duplex mapping and segmental Doppler pressures were blindly compared for their ability to localize a high-grade (50% to 100%) stenosis to the iliac or common femoral arteries, the superficial femoral artery, or the popliteal artery in 151 lower extremities from 79 patients.

RESULTS

Rates of sensitivity and specificity of arterial duplex mapping for identifying a high-grade stenosis at the three arterial levels were 88% and 97%, 95% and 100%, and 78% and 99%, respectively. Those for segmental Doppler pressures were 59% and 86%, 73% and 80%, and 48% and 53%, respectively. There was complete agreement between arterial duplex mapping and angiography in 82% of the limbs studied and between segmental pressures and angiography in 34% of the limbs (p < 0.0001). The presence of diabetes, kidney failure, or previous vascular surgery in the limb studied did not affect the accuracy of either test.

CONCLUSION

Arterial duplex mapping is far superior to segmental Doppler pressures for localization of high-grade angiographic lesions from the iliac to the popliteal arteries.

摘要

目的

本研究旨在比较动脉双功超声成像和节段性多普勒压力测定在非侵入性定位下肢具有血流动力学意义的动脉闭塞性疾病方面的能力。

方法

在进行血管造影对照后，对79例患者的151条下肢，盲目比较动脉双功超声成像和节段性多普勒压力测定将严重狭窄（50%至100%）定位于髂动脉或股总动脉、股浅动脉或腘动脉的能力。

结果

动脉双功超声成像在三个动脉水平识别严重狭窄的敏感性和特异性率分别为88%和97%、95%和100%、78%和99%。节段性多普勒压力测定的敏感性和特异性率分别为59%和86%、73%和80%、48%和53%。在82%的研究肢体中，动脉双功超声成像与血管造影完全一致；在34%的肢体中，节段性压力测定与血管造影完全一致（p<0.0001）。所研究肢体中是否存在糖尿病、肾衰竭或既往血管手术并不影响任何一项检查的准确性。