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目的对比分析实时三维超声成像技术与数字减影血管造影(DSA)对颈动脉狭窄程度诊断的一致性,探讨实时三维超声成像技术在CEA术前的应用价值。方法选取我院脑卒中病房住院患者46例,术前均同期进行常规超声、实时三维超声及DSA检查,以DSA为诊断颈动脉狭窄的金标准,将诊断结果分为两组(狭窄率<70%及狭窄率≥70%),对比分析实时三维超声与DSA检查结果的一致性。结果实时三维超声与DSA检查结果的一致性系数Kappa值为:0.907,P<0.05。实时三维超声和常规二维超声诊断颈动脉狭窄的灵敏度、特异度、阳性预测值、阴性预测值对比结果分别为:94.60%vs 94.59%、96.15%vs 73.08%、94.60%vs71.43%、96.15%vs 95.00%。结论实时三维超声对颈动脉狭窄程度的诊断与DSA具有很好的一致性,且较常规二维超声可作出更加准确的评估,受操作者技术水平等主观因素的影响较小,有望成为CEA术前制定更加合理手术方案的影像学检查手段。
Objective To compare the consistency between real-time three-dimensional ultrasound imaging and digital subtraction angiography (DSA) in the diagnosis of carotid artery stenosis, and to explore the value of real-time three-dimensional ultrasound imaging in the preoperative CEA. Methods Forty-six inpatients with stroke hospital wards were enrolled in this study. Preoperative ultrasound, real-time three-dimensional sonography and DSA were performed before surgery. DSA was the gold standard for diagnosis of carotid artery stenosis. The diagnosis was divided into two groups (stenosis <70 % And stenosis rate≥70%), the consistency between real-time three-dimensional ultrasound and DSA was compared and analyzed. Results The consistency Kappa value of real-time three-dimensional ultrasound and DSA was 0.907, P <0.05. The sensitivity, specificity, positive predictive value and negative predictive value of real-time three-dimensional ultrasound and routine two-dimensional ultrasound in diagnosing carotid artery stenosis were 94.60% vs 94.59%, 96.15% vs 73.08%, 94.60% vs 71.43%, 96.15 % vs 95.00%. Conclusion The diagnosis of carotid artery stenosis by real-time three-dimensional echocardiography has a good agreement with DSA, and can be more accurately evaluated than conventional two-dimensional echocardiography. It is less affected by the subjective factors such as the technical level of the operator and is expected to become a CEA Before the development of a more reasonable surgical imaging examination means.