【摘要】：目的：評(píng)價(jià)彩色多普勒血流顯像(Color doppler flow imagine, CDFI)血流動(dòng)力學(xué)指標(biāo)對(duì)于重度(狹窄率70%-99%)鎖骨下動(dòng)脈狹窄(Subclavian artery stenosis, SAS)的診斷價(jià)值。 方法：收集2009年3月至2013年12月疑似為SAS來我院就診并經(jīng)數(shù)字減影血管造影(Digital subtraction angiography, DSA)證實(shí)的患者252例,狹窄程度分為中度狹窄(50%-69%)、重度狹窄(70%-99%)。利用彩色多普勒血流顯像,記錄鎖骨下動(dòng)脈狹窄段殘余管腔直徑(Dr)、收縮期峰值流速(PSV1)和舒張末流速(EDV),并記錄管徑相對(duì)正常的狹窄遠(yuǎn)端原始管腔直徑(Do)和收縮期峰值流速(PSV2),計(jì)算直徑狹窄率(1-Dr/Do)和峰值流速比值(PSV1/PSV2);以DSA檢查結(jié)果作為參考,通過接收者操作特征曲線(ROC曲線)分析,得出鎖骨下動(dòng)脈重度狹窄(70%-99%)患者上述指標(biāo)的理想臨界值及其診斷價(jià)值。 結(jié)果：在252例患者中,109例診斷為重度SAS(70%-99%),143例為中度SAS(50%-69%)。評(píng)價(jià)重度SAS(70%-99%)的指標(biāo)理想臨界值分別為：PSV1≥343cm/s, EDV≥60cm/s, PSV1/PSV2≥4.0;診斷重度SAS(70%-99%)指標(biāo)準(zhǔn)確率分別為：PSV1為86.1%,EDV為85.7%,PSVl/PSV2為84.9%,1-Dr/Do為80.2%。另外,如果PSV1結(jié)合EDV和1-Dr/Do作為診斷指標(biāo),診斷準(zhǔn)確率將從86.1%上升到87.3%；如果PSV1結(jié)合EDV和PSV1/PSV2作為診斷指標(biāo),診斷準(zhǔn)確率將達(dá)到95.8%。 結(jié)論：彩色多普勒血流顯像血流動(dòng)力學(xué)指標(biāo)PSV1, EDV和PSV1/PSV2在診斷重度SAS(70%-99%)上與DSA具有良好的一致性,聯(lián)合運(yùn)用三個(gè)指標(biāo)可以大大提高診斷準(zhǔn)確率。
[Abstract]:Objective: to evaluate the diagnostic value of color Doppler flow imaging (Color doppler flow imagine, CDFI) hemodynamics in severe (70-99%) subclavian artery stenosis with (Subclavian artery stenosis, SAS). Methods: from March 2009 to December 2013, 252 patients with suspected SAS who were confirmed by digital subtraction angiography (Digital subtraction angiography, DSA) were divided into moderate stenosis (50-69%) and severe stenosis (70-99%). Using color Doppler flow imaging, (Dr), peak systolic velocity (PSV1) and end-diastolic velocity (EDV),) of residual lumen diameter in the stenosis segment of subclavian artery were recorded. The original lumen diameter (Do) and peak systolic peak velocity (PSV2) of the distal stenosis with normal diameter were recorded. The diameter stenosis rate (1-Dr/Do) was calculated. And peak velocity ratio (PSV1/PSV2). The results of DSA were used as a reference. The ideal critical value and diagnostic value of the above indexes in patients with severe subclavian artery stenosis (70-99%) were obtained by the analysis of the receiver operating characteristic curve (ROC curve). Results: of the 252 cases, 109 cases were diagnosed as severe SAS (70-99%), 143 cases were moderate SAS (50-69%). The ideal critical values for evaluating severe SAS (70-99%) were as follows: PSV1 鈮，

本文編號(hào)：2196152