双功能超声和磁共振血管造影及数字减影血管造影评估颅外颈？…

评价双功能多普勒超声，磁共振血管造影和数字减影血管造影诊断颅外颈内动脉狭窄的相关性。方法３２例患者同时接受颈动脉多普勒超声、ＭＲＡ和ＤＳＡ检查。狭窄度计算方法同ＮＡＳＣＥＴ。结果超声和ＭＲＡ检查中未出现并发症，１例（３．１％）在ＤＳＡ术后出现脑梗塞症状。彩色多普勒与ＤＳＡ比较，Ｋａｐｐａ＝０．７８，超声诊断重度狭窄和中度以上狭窄的敏感度，特异度，准确度分别是７８％、９６％、９２％和９７％、９１％、

Assessment of extracranial internal carotid artery stenosis by duplex scanning magnetic resonance angiography and digital subtraction angiography: a comparative study]

OBJECTIVE: To investigate the correlation between duplex scanning, magnetic resonance angiography (MRA), and digital subtraction angiography (DSA) in the evaluation of extracranial internal carotid artery (EICA) stenosis. METHODS: All the examinations mentioned-above were performed on 32 patients. According to NASCET, EICA stenosis were classified into four grades: mild (the diameter reduction < 30%), moderate (31% approximately 69%), severe (70% approximately 99%), and total occlusion. RESULTS: One (3.1%) patient suffered from acute brain infarction after DSA. To compare duplex with DSA, Kappa = 0.78, and by the use of a severe or a greater than 30% stenosis as a positive study, the sensitivity, specificity and accuracy were 78%, 95%, 92% and 97%, 91%, 94%, respectively. To compare MRA with DSA, Kappa = 0.73, and with the same criteria, the sensitivity, specificity and accuracy were 78%, 90%, 89% and 97%, 91%, 94%, respectively. In the evaluation where the results of duplex and MRA were in agreement, to compare duplex + MRA with DSA, Kappa = 0.93, and the sensitivity, specificity and accuracy in the diagnosis of severe stenosis were 100%, 95% and 96%, and the accuracy in the diagnosis of > 30% stenosis was 100%. CONCLUSIONS: There is good correlativity between duplex scanning, MRA and DSA in the examination of EICA stenosis. A combination of duplex and MRA with their results in agreement may ultimately eliminate the need of DSA in the evaluation of EICA stenosis.