摘要
目的分析视神经鞘超声联合经颅多普勒超声检测对缺血性脑卒中的评估价值。方法纳入80例缺血性脑卒中疑似患者,均行经颅多普勒超声检查和视神经鞘超声检查,将脑血管造影作为疾病诊断金标准,对比两种方式单独使用与联合使用的疾病诊断效能,不同部位和不同程度大脑动脉狭窄检出率,另对比健康者与缺血性脑卒中患者超声征象。结果经颅多普勒超声诊断灵敏度、特异度、准确性、阳性预测值和阴性预测值与视神经鞘超声对比差异无统计学意义(P>0.05)。联合方式各项诊断效能分别为95.24%、92.11%、93.75%、93.02%和94.59%,明显高于单一诊断方式,组间对比差异有统计学意义(P<0.05)。经颅多普勒超声联合视神经鞘超声对大脑中动脉狭窄、前动脉狭窄、大脑后动脉狭窄、颈内动脉终末段狭窄、基底动脉狭窄和椎动脉狭窄的总检出率为95.83%,明显高于经颅多普勒超声检查,组间对比差异有统计学意义(P<0.05)。视神经鞘超声联合经颅多普勒超声对不同程度(轻度、中度、重度和完全闭塞)动脉狭窄总检出率为93.75%,高于经颅多普勒超声,组间差异有统计学意义(P<0.05)。缺血性脑卒中患者平均收缩期血流速度为(59.96±7.45)cm/s,平均血流速度为(38.54±3.12)cm/s,舒张期血流速度为(24.48±4.27)cm/s,明显低于正常人(136.18±14.32)cm/s、(85.21±5.68)cm/s和(60.72±3.96)cm/s,视神经鞘直径为(5.12±0.58)mm,颅内压为(22.72±3.45)mmHg,高于正常人(4.32±0.44)mm和(10.32±1.15)mmHg,两组对比差异有统计学意义(P<0.05)。结论经颅多普勒超声联合视神经鞘超声可准确诊断缺血性脑卒中,也可检出狭窄部位和狭窄程度,可通过超声参数对疾病进行鉴别诊断,有推广价值。
Objective To analyze the evaluation value of combined detection of optic nerve sheath ultrasound and transcranial Doppler ultrasound in ischemic stroke patients.Methods A total of 80 suspected ischemic stroke patients were included and underwent transcranial Doppler ultrasound examination and optic nerve sheath ultrasound examination.Cerebrovascular angiography was used as the gold standard for disease diagnosis.The diagnostic efficacy of the two methods alone and combined was compared,the detection rate of different parts and different degrees of cerebral artery stenosis,and the ultrasound signs of healthy patients with ischemic stroke were compared.Results There was no difference in diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value between transcranial Doppler ultrasonography and optic nerve vaginalis ultrasonography(P>0.05).The diagnostic efficacy of combined ultrasonography was 95.24%,92.11%,93.75%,93.02%and 94.59%,respectively,which was significantly higher than that of single ultrasonography.There was significant difference in comparison between groups(P<0.05).The total detection rate of transcranial Doppler ultrasonography combined with optic nerve sheathing ultrasonography for middle cerebral artery stenosis,anterior artery stenosis,posterior cerebral artery stenosis,internal carotid artery stenosis,basilar artery stenosis and vertebral artery stenosis was 95.83%,which was significantly higher than that of transcranial Doppler ultrasonography(P<0.05).The total detection rate of arterial stenosis in different degrees(mild,moderate,severe,and complete occlusion)by optic nerve sheath ultrasound plus transcranial Doppler ultrasound was 93.75%,higher than that by transcranial Doppler ultrasound alone,with a significant intergroup difference(P<0.05).The mean systolic blood flow velocity in ischemic stroke patients was(59.96±7.45)cm/s,the mean blood flow velocity was(38.54±3.12)cm/s,and the diastolic blood flow velocity was(24.48±4.27)cm/s,which was significan
作者
王瑞琼
饶霜霜
武立月
Wang Ruiqiong;Rao Shuangshuang;Wu Liyue(Department of Ultrasonography,The Third People's Hospital of Henan Province,Zhengzhou,Henan 450000,China)
出处
《中国微侵袭神经外科杂志》
CAS
2023年第12期90-94,共5页
Chinese Journal of Minimally Invasive Neurosurgery
