超声造影对非动脉炎性前部缺血性视神经病变患者视网膜中央动脉血流状态的初步研究

摘要

目的 应用超声造影测定非动脉炎性前部缺血性视神经病变(NAION)患者视网膜中央动脉(CRA)的血流速度及血管走行.方法 选取我院经临床确诊的NAION患者16例(患病组,17眼)和正常成人13例(对照组,13眼),采集两组彩色多普勒和超声造影所测CRA,并对两组间进行比较;ROC曲线分析彩色多普勒与超声造影对NAION的诊断效能,并对二者进行比较.结果 超声造影所测患病组CRA血流速度为(7.15±0.89)cm/s,对照组CRA血流速度为(9.64±0.87)cm/s,差异有统计学意义(P<0.01);彩色多普勒所测患病组CRA血流速度分别为(10.27±1.42)cm/s,对照组CRA血流速度为(11.86±1.69)cm/s,差异有统计学意义(P<0.01).超声造影诊断NAION的ROC曲线下面积为0.964,彩色多普勒诊断NAION的ROC曲线下面积为0.747,二者比较差异有统计学意义(P<0.05).结论 超声造影可直观、动态地观察CRA的血流状态,评估血管走行,更优于彩色多普勒,为临床评估CRA提供了一种新的技术手段.%Objective To determinate the blood flow velocity and vessels of central retinal artery(CRA)in patients with nonarteritc anterior ischemic optic neuropathy(NAION)by contrast-enhanced ultrasonography(CEUS). Methods CDFI and CEUS were performed on 16 patients clinically diagnosed as NAION(NAION group,17 eyes)and 13 normal cases(normal group, 13 eyes).The real-time image and the flow velocity of CRA by CEUS were analyzed comparatively between two groups.The flow velocity of CRA was also detected by CDFI,and the result was compared with contrast-enhanced ultrasound. The diagnostic efficiency of CDFI and CEUS for NAION were analyzed by ROC curve.Results By CEUS,the flow velocity of CRA in NAION group was(7.15±0.89)cm/s,and that of normal group was(9.64±0.87)cm/s,there was significant difference(P<0.01).By CDFI,the flow velocity of CRA in NAION group was(10.27±1.42)cm/s,and that of normal group was(11.86±1.69)cm/s,there was significant difference(P<0.01). The area under curve(AUC)by CEUS for NAION was 0.964,the AUC by CDFI for NAION was 0.964, there was significant difference(P<0.05). Conclusion CEUS is a new visualized and real-time techology for evaluation of the flow velocity of CRA and the diagnosis of NAION,which is more sensitive than CDFI.