Correlation of Hemodynamically Significant Internal Carotid Stenosis with Pulsed Doppler Frequency Analysis
Correlation of Hemodynamically Significant Internal Carotid Stenosis with Pulsed Doppler Frequency Analysis
复制标题
血流动力学显着的颈内动脉狭窄与脉冲多普勒频率分析的相关性
DOI：
10.1097/00000658-198404000-00016
复制
发表时间：
1984
影响因子：
9
通讯作者：
M. Farber
中科院分区：
文献类型：
--
作者：
W. M. Blackshear;S. Lamb;V. Kollipara;J. D. Anderson;F. Murtagh;C. P. Shah;M. Farber
在90例患者的动脉中进行颈动脉内膜切除术时测量颈内动脉狭窄处的收缩压差和平均压差，所有患者均接受血管造影。其中82名患者还进行了脉冲多普勒超声动脉造影和实时频谱分析。有71例（79%）高度狭窄，血管造影直径缩小超过50%。41例患者（46%）确定了显著的收缩压差（≥：10 mmHg），其中38例（46%）接受了超声评估。在狭窄内测量的脉冲多普勒频率等于或大于6.5kHz时，识别降压病变的敏感性为94.7%（36/38），特异性为47.7%（21/44）。阳性预测值为61%（36/59）。血管造影标准（直径缩小50%）显示敏感性为97.6%（40/41），特异性为36.7%（18/49），阳性预测值为56.3%（40/71）。血管造影阴性预测值为94.7%，超声动脉造影阴性预测值为91.3%。脉冲多普勒频率等于或大于6.5千赫兹似乎可以准确识别在手术条件下有降低远端颈内动脉压力风险的病变，其灵敏度与血管造影相似。该标准具有阳性预测值和特异性，略上级血管造影和高阴性预测值。脉冲多普勒频谱分析提供了与血流速度相关的生理信息，与血管造影术提供的解剖数据互补，用于评估颈内动脉狭窄的血流动力学意义。
Systolic and mean pressure gradients across internal carotid stenoses were measured at the time of carotid endarterectomy in the arteries of 90 patients, all of whom underwent angiography. Eighty-two of these patients also had pulsed Doppler ultrasonic arteriography with real-time spectrum analysis. There were 71 (79%) high grade stenoses, of greater than 50% diameter reduction by angiography. Significant systolic pressure gradients (≥:10 mmHg) were identified in 41 patients (46%), 38 (46%) of whom underwent ultrasonic evaluation. A pulsed Doppler frequency measured within the stenosis equal to or greater than 6.5 kiloHertz had a sensitivity of 94.7% (36/38) in identifying pressure reducing lesions with a specificity of 47.7% (21/44). Positive predictive value was 61% (36/59). Angiographic criteria (50% diameter reduction) exhibited a sensitivity of 97.6% (40/41), a specificity of 36.7% (18/49) and a positive predictive value of 56.3% (40/71). Negative predictive value was 94.7% for angiography and 91.3% for ultrasonic arteriography. A pulsed Doppler frequency equal to or greater than 6.5 kiloHertz appears to accurately identify lesions that are at risk to reduce distal internal carotid pressure under operative conditions with a sensitivity similar to angiography. This criterion has a positive predictive value and specificity that is slightly superior to angiography and a high negative predictive value. Pulsed Doppler spectrum analysis provides physiologic information relative to blood flow velocity that is complimentary to the anatomic data provided by angiography for assessing the potential for hemo-dynamic significance of internal carotid stenoses.
无症状颈动脉杂音和狭窄：重新评估。
影响因子：
8.3
作者：
Yatsu,FM;Hart,RG
通讯作者：
Hart,RG