论文部分内容阅读
目的:评价经颅多普勒超声（TCD）用于诊断脑梗死患者颅内动脉狭窄的临床价值。方法:选取2018年12月至2020年12月诸暨市中医医院收治的脑梗死患者120例为研究对象，所有患者均进行CT血管造影检测（CTA）和TCD检测，统计TCD和CTA检测对不同位置颅内动脉的狭窄情况的诊断结果，以CTA检测结果为金标准，统计TCD检测对不同位置颅内动脉狭窄的诊断效能指标，评价TCD与CTA检测对不同位置颅内动脉狭窄诊断结果的一致性。结果:TCD检测对双侧大脑中动脉狭窄、大脑前动脉、大脑后动脉、基底动脉、双侧椎动脉和颈内动脉虹吸段狭窄的诊断灵敏度分别为89.47%、91.18%、85.00%、90.62%、81.82%和96.55%，TCD检测对不同位置颅内动脉狭窄的诊断特异度分别为87.30%、95.35%、91.25%、94.32%、96.33%和87.88%。TCD与CTA检测对双侧大脑中动脉狭窄、大脑前动脉、大脑后动脉、基底动脉、双侧椎动脉和颈内动脉虹吸段狭窄诊断结果的一致性Kappa值分别为0.766，0.858、0.758、0.833、0.800和0.852。结论:TCD检测对于不同位置颅内动脉狭窄的诊断灵敏度和特异度均较高，与CTA检测结果一致性好，具有较高临床应用价值。“,”Objective:To evaluate the application value of transcranial Doppler in the detection of intracranial artery stenosis in patients with cerebral infarction.Methods:120 patients with cerebral infarction who received treatment in Zhuji Hospital of Traditional Chinese Medicine from December 2018 to December 2020 were included in this study. The patients underwent CT angiography and transcranial Doppler examination. The results of CT angiography and transcranial Doppler examination for screening intracranial artery stenosis at different locations were evaluated. Taking CT angiography results as the gold standard, the efficacy of transcranial Doppler examination for screening intracranial artery stenosis at different locations was determined. The consistency of transcranial Doppler examination n versus CT angiography in screening intracranial necrosis at different locations was evaluated.n Results:The sensitivity of transcranial Doppler examination in the detection of intracranial artery stenosis at bilateral middle cerebral arteries, anterior cerebral artery, posterior cerebral artery, basilar artery, bilateral vertebral arteries, and internal carotid artery (Siphon segment) was 89.47%, 91.18%, 85.00%, 90.62%, 81.82%, 96.55%, respectively. The specificity of transcranial Doppler examination in the detection of intracranial necrosis at bilateral middle cerebral arteries, anterior cerebral artery, posterior cerebral artery, basilar artery, bilateral vertebral arteries, and internal carotid artery (Siphon segment) was 87.30%, 95.35%, 91.25%, 94.32%, 96.33%, and 87.88%, respectively. The Kappa value for judging the consistency between transcranial Doppler examination and CT angiography in the detection of intracranial artery stenosis at bilateral middle cerebral arteries, anterior cerebral artery, posterior cerebral artery, basilar artery, bilateral vertebral arteries, and internal carotid artery (Siphon segment) was 0.766, 0.858, 0.758, 0.833, 0.800, and 0.852, respectively.Conclusion:Transcranial Doppler examination has high sensitivity and specificity in the detection of intracranial artery stenosis at different locations. Its screening results are highly consistent with those from CT angiography. Transcranial Doppler examination is of high clinical application value.