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颈部血管彩超与磁共振在诊断颈动脉狭窄中的应用比较

作者:李红艳1 付雪莲2 李延新3

所属单位:1.陕西省延安市博爱医院影像科(陕西 延安 716000) 2.陕西省延安市博爱医院超声科(陕西 延安 716000) 3.延安大学附属医院病理科(陕西 延安 716000)

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摘要

目的探讨颈部血管彩超与磁共 振(MRI)在诊断颈动脉狭窄中的应用价 值。方法 回顾性分析2016年1月-2018年 1月陕西省延安市博爱医院收治的86例缺 血性脑血管疾病患者的临床资料,行MRI 检查的40例患者纳入A组,行颈部血管 彩超检查的46例患者纳入B组,两组患者 均接受数字减影血管造影(DSA)检查。以 DSA检查结果为“金标准”,评价MRI与颈 部血管彩超对颈动脉狭窄的诊断价值, 并分析该疾病的影像学特点。结果 MRI 诊断颈动脉狭窄的灵敏度、特异度、准 确率:1级为93.33%、86.67%、90.67%, 2级为75.00%、94.92%、90.67%,3级 为90.91%、98.44%、97.33%,4级为 100%、100%、100%。颈部血管彩超诊断 颈动脉狭窄的灵敏度、特异度、准确 率:1级为92.16%、90.63%、91.57%,2 级为82.35%、92.43%、90.36%,3级为 83.33%、98.59%、96.39%,4级为100%、 100%、100%。结论 MRI与颈部血管彩超对 颈动脉狭窄的诊断准确性均较高,且差异 性不大,两种检查方法均有较高的临床应 用价值。

Objective To explore the application value of neck vascular color Doppler ultrasound and magnetic resonance imaging (MRI) in carotid artery stenosis. Methods The clinical data of 86 patients with ischemic cerebrovascular disease admitted to the Bo'ai Hospital of Yan'an from January 2016 to January 2018 were analyzed retrospectively. A total of 40 cases with MRI were included in group A, and 46 cases with neck vascular color Doppler ultrasound were included in group B. The two groups were accepted digital subtraction angiography (DSA) examination. The DSA test results were taken as "gold standard", and the diagnostic value of MRI and neck vascular color Doppler ultrasound on carotid artery stenosis was evaluated, and the imaging features of disease were analyzed. Results The sensitivity, specificity and accuracy of MRI detection for carotid artery stenosiswere 93.33%, 86.67% and 90.67% for grade 1, were 75.00%, 94.92% and 90.67% for grade 2, and were 90.91%, 98.44% and 97.33% for grade 3, and were 100%, 100% and 100% for grade 4. The sensitivity, specificity and accuracy of neck vascular color Doppler ultrasound examination for carotid artery stenosis were 92.16%, 90.63% and 91.57% for grade 1, and were 82.35%, 92.43% and 90.36% for grade 2, and were 83.33%, 98.59% and 96.39% for grade 3, and were 100%, 100% and 100% for grade 4. Conclusion Both of MRI and neck vascular color Doppler ultrasound have high diagnostic accuracy for carotid artery stenosis, and both of the two methods have high clinical application value.

【关键词】MRI;颈部血管彩超;DSA; 颈动脉狭窄;诊断价值

【中图分类号】R743;R445

【文献标识码】A

【DOI】10.3969/j.issn.1672-5131.2018.12.008

前言

颈动脉狭窄多见于中老年人,最主要的病因是动脉粥样硬化,常 伴随多种心血管危险因素,是造成缺血性脑血管疾病的重要原因之 一。该疾病的治疗目的在于缓解颈动脉狭窄引发的脑缺血症状,临床 上对不同程度的颈动脉狭窄采取不同的治疗措施,为改善预后,需要 对该疾病的严重程度有明确诊断[1]。数字减影血管造影(DSA)一直是诊 断颈动脉狭窄的“金标准”,对治疗方案的选择有指导性作用,但其 有创,不试用于普查、初诊和随访,寻找无创且准确性高的检查手段 一直是研究热点[2]。MRI和颈部血管彩超作为分辨率较高且检查便利的 影像学技术,近年来已广泛应用于颈部血管疾病的诊断。本研究旨在 探讨MRI与颈部血管彩超对颈动脉狭窄的诊断价值,现报道如下。