颈动脉SMI技术与血管超声诊断脑梗死患者颈动脉狭窄的临床价值

摘要

目的 比较颈动脉超微血流成像(SMI)与血管超声诊断脑梗死患者颈动脉狭窄的临床价值.方法 回顾性分析衡水市哈励逊国际和平医院2015年6月至2017年6月收治的202例(共282条血管)脑梗死患者的常规血管超声、颈动脉SMI影像学资料,以数字减影血管造影(DSA)为金标准,比较分析SMI、血管超声诊断颈动脉狭窄的敏感度、特异度及准确度.结果 以DSA为金标准,常规血管超声、SMI与DSA对颈动脉狭窄的一致性均较好(Kappa=0.615、0.750,P<0.05);以DSA为金标准,常规血管超声诊断中度狭窄的特异度、准确度分别为82.06%、84.75%,均明显低于SMI的90.77%、92.20%,差异均有统计学意义(P<0.05);SMI诊断轻度、重度、完全闭塞敏感度、特异度、准确度均高于常规血管超声,但差异均无统计学意义(P>0.05).结论 颈动脉SMI、常规血管超声均能较好地显示脑梗死患者颈动脉狭窄程度,但SMI相比血管超声诊断颈动脉狭窄更准确.%Objective To compare the clinical value of carotid artery superb micro-vascular imaging(SMI)ver-sus vascular ultrasound in the diagnosis of carotid artery stenosis in patients with cerebral infarction.Methods The im-aging data of conventional vascular ultrasound and carotid artery SMI of 202 patients(a total of 282 vessels)with cere-bral infarction who were admitted to the Halison International Peace Hospital of Hengshui City from June 2015 to June 2017 were analyzed retrospectively.With the digital subtraction angiography(DSA)as the golden standard,the sensitivi-ty,specificity and accuracy were compared between SMI and vascular ultrasound in the diagnosis of carotid artery steno-sis.Results With DSA as the golden standard,the consistency of conventional vascular ultrasound,SMI and DSA for carotid artery stenosis was good(Kappa=0.615,0.750,P<0.05).With DSA as the golden standard,the specificity and ac-curacy of conventional vascular ultrasound in the diagnosis of moderate stenosis were respectively 82.06% and 84.75%, which were significantly lower than 90.77% and 92.20% of SMI(P<0.05).The sensitivity,specificity and accuracy of SMI in the diagnosis of mild,severe and complete occlusion were significantly lower than those of conventional vascu-lar ultrasound,with statistical significance(P<0.05).Conclusion Both of carotid artery SMI and conventional vascular ultrasound can well display the degree of carotid artery stenosis in patients with cerebral infarction.However,the diag-nostic accuracy of SMI is higher than that of vascular ultrasound.