急性缺血性脑卒中患者颅内外血管狭窄诊断中经颅多普勒超声的应用及其准确性研究
|
摘要
目的分析经颅多普勒超声在急性缺血性脑卒中患者颅内外血管狭窄临床诊断中的应用价值和准确性。方法选取2014年1月至2018年12月100例医院收治的急性缺血性脑卒中患者,所有患者在入院之后均行常规经颅多普勒超声检查,并将超声检查结果与计算机血管成像检查结果进行对照分析,观察经颅多普勒超声检查的诊断准确率。结果经颅多普勒超声检查对于颅内外血管狭窄的诊断准确率存在较大的差异,经颅多普勒超声检查对于颅内外血管狭窄的诊断准确率存在较大的差异,对于颅内动脉血管狭窄的敏感性、特异性为96.2%和98.6%;对椎-基底动脉系统血管狭窄的敏感性、特异性为71.1%和94.3%,且经颅多普勒超声检查能够观察到计算机血管成像无法观察到的信息,例如微栓子状况、侧支循环血流状况等。结论经颅多普勒超声检查在急性缺血性脑卒中患者颅内外血管狭窄临床诊断中具有较好的应用效果,尤其是颅内动脉血管狭窄具有较高的敏感性与特异性,同时能够观察到计算机血管成像无法观察到的血流动力学指标。
Objective Analysis Application value and accuracy of transcranial Doppler ultrasound in clinical diagnosis of intracranial andextracranial vascular stenosis in patients with acute ischemic stroke.Methods 100 patients with acute ischemic stroke admitted to hospital from January 2014 to December 2018,all patients were treated with routine transcranial doppler ultrasonography after admission,and the results of ultrasonography were compared with those of computer angiography,and the diagnostic accuracy of transcranial Doppler ultrasonography was observed.Results The diagnosis and accuracy of intracranial and extracranial vascular stenosis were significantly different by transcranial Doppler ultrasonography,and the diagnostic accuracy of intracranial and extracranial vascular stenosis was significantly different,and the sensitivity and specificity of intracranial artery stenosis were 96.2% and 98.6%.The sensitivity and specificity of vascular stenosis in vertebral-basilar artery system were 71.1% and 94.3%,and transcranial Doppler ultrasonography could observe the information that could not be observed by computer angiography,such as the condition of micro-embolus and the condition of lateral circulation blood flow.Conclusion Transcranial Doppler ultrasonography has a good effect in the clinical diagnosis of intracranial and extracranial vascular stenosis in patients with acute ischemic stroke,especially the high sensitivity and specificity of intracranial artery stenosis,and can observe the hemodynamic indexes that cannot be observed by computer angiography.
Objective Analysis Application value and accuracy of transcranial Doppler ultrasound in clinical diagnosis of intracranial andextracranial vascular stenosis in patients with acute ischemic stroke.Methods 100 patients with acute ischemic stroke admitted to hospital from January 2014 to December 2018,all patients were treated with routine transcranial doppler ultrasonography after admission,and the results of ultrasonography were compared with those of computer angiography,and the diagnostic accuracy of transcranial Doppler ultrasonography was observed.Results The diagnosis and accuracy of intracranial and extracranial vascular stenosis were significantly different by transcranial Doppler ultrasonography,and the diagnostic accuracy of intracranial and extracranial vascular stenosis was significantly different,and the sensitivity and specificity of intracranial artery stenosis were 96.2% and 98.6%.The sensitivity and specificity of vascular stenosis in vertebral-basilar artery system were 71.1% and 94.3%,and transcranial Doppler ultrasonography could observe the information that could not be observed by computer angiography,such as the condition of micro-embolus and the condition of lateral circulation blood flow.Conclusion Transcranial Doppler ultrasonography has a good effect in the clinical diagnosis of intracranial and extracranial vascular stenosis in patients with acute ischemic stroke,especially the high sensitivity and specificity of intracranial artery stenosis,and can observe the hemodynamic indexes that cannot be observed by computer angiography.
引文
[1] 臧丽娥,隋汝波,张磊等.经颅多普勒超声对急性缺血性脑卒中患者颅内外血管狭窄诊断准确性的研究[J].中国医科大学学报,2015,44(8):734-737.
[2] 李娜,华扬,贾凌云等.缺血性卒中住院患者年龄特征与头颈部大动脉病变分布的多中心研究结果分析[J].中国脑血管病杂志,2017,14(6):285-291.
[3] 陈海燕.颈部血管彩色多普勒超声和经颅多普勒超声在脑卒中高危人群筛查中的应用[J].现代实用医学,2017,29(11):1422-1424.
[4] 左凤同,刘辉,吴慧君等.双重抗血小板聚集治疗对伴有颅内外血管狭窄的缺血性卒中患者的二级预防[J].实用医学杂志,2015,31(15):2559-2561.
[5] 赵婷,范学文,李芳等.高同型半胱氨酸血症与缺血性脑卒中患者颅内动脉狭窄的相关性[J].宁夏医学杂志,2015,37(6):484-486.
[6] 黄治飞,朱幼玲,周群等.γ-谷氨酰转移酶与缺血性脑卒中患者颅内外动脉粥样硬化性狭窄的相关性研究[J].中华老年心脑血管病杂志,2017,19(10):1058-1061.
[7] 项静,晁文波,刘文博等.缺血性脑卒中合并T2 DM患者的颅内外动脉狭窄状况研究[J].医学临床研究,2016,33(7):1429-1430.
[8] 林春艳.缺血性脑卒中患者颅内外动脉狭窄分布及影响因素分析[J].国际医药卫生导报,2016,22(18):2776-2778.
[9] 贾凌云,华扬,邢英琦等.血管超声对短暂性脑缺血发作(TIA)与缺血性脑卒中住院患者颅内外动脉病变的多中心检查登记研究设计方案[J].中国脑血管病杂志,2017,14(6):281-284.
[10] 陈彬,孙玉芳,王云峰等.合并颅内外其他血管闭塞是大脑中动脉闭塞患者卒中再发的预测因素[J].神经损伤与功能重建,2015,23(3):201-203.
[2] 李娜,华扬,贾凌云等.缺血性卒中住院患者年龄特征与头颈部大动脉病变分布的多中心研究结果分析[J].中国脑血管病杂志,2017,14(6):285-291.
[3] 陈海燕.颈部血管彩色多普勒超声和经颅多普勒超声在脑卒中高危人群筛查中的应用[J].现代实用医学,2017,29(11):1422-1424.
[4] 左凤同,刘辉,吴慧君等.双重抗血小板聚集治疗对伴有颅内外血管狭窄的缺血性卒中患者的二级预防[J].实用医学杂志,2015,31(15):2559-2561.
[5] 赵婷,范学文,李芳等.高同型半胱氨酸血症与缺血性脑卒中患者颅内动脉狭窄的相关性[J].宁夏医学杂志,2015,37(6):484-486.
[6] 黄治飞,朱幼玲,周群等.γ-谷氨酰转移酶与缺血性脑卒中患者颅内外动脉粥样硬化性狭窄的相关性研究[J].中华老年心脑血管病杂志,2017,19(10):1058-1061.
[7] 项静,晁文波,刘文博等.缺血性脑卒中合并T2 DM患者的颅内外动脉狭窄状况研究[J].医学临床研究,2016,33(7):1429-1430.
[8] 林春艳.缺血性脑卒中患者颅内外动脉狭窄分布及影响因素分析[J].国际医药卫生导报,2016,22(18):2776-2778.
[9] 贾凌云,华扬,邢英琦等.血管超声对短暂性脑缺血发作(TIA)与缺血性脑卒中住院患者颅内外动脉病变的多中心检查登记研究设计方案[J].中国脑血管病杂志,2017,14(6):281-284.
[10] 陈彬,孙玉芳,王云峰等.合并颅内外其他血管闭塞是大脑中动脉闭塞患者卒中再发的预测因素[J].神经损伤与功能重建,2015,23(3):201-203.