中国卒中杂志2019，Vol.14Issue(8)：770-774,5.DOI:10.3969/j.issn.1673-5765.2019.08.007
比较经颅超声造影和数字减影血管造影对大脑中动脉狭窄的诊断价值研究
Diagnostic Value of Transcranial Contrast-enhanced Ultrasound and Digital Subtraction Angiography for Middle Cerebral Artery Stenosis
摘要
Abstract
Objective To investigate the diagnostic value of transcranial contrast-enhanced ultrasound (t-CEUS) and digital subtraction angiography (DSA) for middle cerebral artery (MCA) stenosis or occlusion. Methods A total of 197 patients with suspected MCA stenosis or occlusion from December 2017 to April 2019 were enrolled. A total of 225 stenostic or occluded MCAs were diagnosed by t-CEUS and DSA, according to the degree of MCA stenosis, the MCAs were divided into four groups:mild (30%-50%), moderate (50%-69%), severe (70%-99%) and occlusion (100%). Taking DSA diagnosis as the golden standard, the specificity, sensitivity, and accuracy of t-CEUS diagnosis were analyzed by comparing the results of ultrasound imaging. Results Of all the 197 patients, 132 male and 65 female, with the average age (58.4+4.6) years and the range 43 to 72 years. Of 225 MCAs diagnosed by DSA, 16 MCAs were mild, 70 were moderate, 121 were severe, and 18 were occluded. Of 224 MCAs diagnosed by t-CEUS, 18 were mild, 76 were moderate, 112 were severe, and 18 were occluded. The diagnosis of MCA stenosis/occlusion using t-CEUS and DSA had a high consistency (Kappa=0.91). The sensitivity, specificity and accuracy of t-CEUS for the diagnosis of mild MCAs were 80%, 80%, and 91%, respectively; the sensitivity, specificity and accuracy of t-CEUS for the diagnosis of moderate MCAs were 83%, 93%, and 97%, respectively; the sensitivity, specificity and accuracy of t-CEUS for the diagnosis of severe MCA were 83%, 96%, and 96%, respectively. Conclusions t-CEUS can clearly show mild, moderate and severe stenosis and occlusion in MCAs, and it is suitable for the diagnosis of patients with MCA stenosis and occlusion, especially for the patients with suspected MCA stenosis and who are not suitable for DSA.关键词
大脑中动脉/狭窄/经颅超声造影/数字减影血管造影Key words
Middle cerebral artery/Stenosis/Transcranial contrast-enhanced ultrasound/Digital subtraction angiography引用本文复制引用
张惠琴,王立淑,田凤兰,王坤,徐冬娟,何文..比较经颅超声造影和数字减影血管造影对大脑中动脉狭窄的诊断价值研究[J].中国卒中杂志,2019,14(8):770-774,5.基金项目
国家自然基金重点项目(81730050) （81730050）
