Color Doppler Imaging Evaluation of Proximal Vertebral Artery Stenosis
Color Doppler Imaging Evaluation of Proximal Vertebral Artery Stenosis
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DOI：
10.2214/ajr.09.2624
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发表时间：
2009-11-01
影响因子：
5
通讯作者：
Liu, Ji-Bin
中科院分区：
文献类型：
--
作者：
Hua, Yang;Meng, Xiu-Feng;Liu, Ji-Bin
目标。椎动脉狭窄的超声诊断标准还没有得到充分的研究。本研究的目的是评价彩色多普勒血流动力学参数，并以数字减影血管造影术为参考标准，确定评价椎动脉近端狭窄的最佳阈值。在653例有后循环缺血症状的患者中，247例经数字减影血管造影术证实椎动脉近端动脉正常或狭窄。测量椎动脉起始处和椎间节段的收缩峰值速度(PSVOrigin)和舒张期末期血流速度(PSVIV)，测量椎动脉起始处和椎间节段的舒张末速度和血管管腔的直径。结果：评价椎动脉近端狭窄的最佳血流动力学参数界值为PSVOrigin=85 cm/S，PSVOrigin/PSVIV>；=1.3，起始处舒张末血流速度=27 cm/S，50~69%狭窄的血流动力学参数为PSVOrigin>；=140 cm/S，PSVOrigin/PSVIV>；结论彩色多普勒超声对椎动脉狭窄的诊断准确率为94.5%、96.2%、88.7%，对椎动脉狭窄的诊断准确率分别为94.5%、96.2%、88.7%。本研究结果可为制定椎动脉近端狭窄的超声诊断标准提供参考。
OBJECTIVE. The sonographic diagnostic criteria for vertebral artery stenosis have not been fully investigated. The purpose of this study was to assess hemodynamic parameters at color Doppler imaging and to determine, with digital subtraction angiography as the reference standard, the optimal thresholds for evaluation of proximal vertebral artery stenosis.MATERIALS AND METHODS. Among 653 patients with symptoms of ischemia of the posterior circulation, 247 subjects with normal arteries or stenosis of the proximal vertebral artery confirmed with digital subtraction angiography were included in the study. Peak systolic velocity at the origin of the vertebral artery (PSVorigin) and in intervertebral segments of the vertebral artery (PSVIV), end-diastolic velocity at the origin and in the intervertebral segments of the vertebral artery, and the diameter of the vascular lumen were measured. The cutoff values for the diagnosis of < 50%, 50-69%, and 70-99% stenosis were determined with receiver operating characteristics analysis.RESULTS. The optimal cutoff values of hemodynamic parameters in evaluation of stenosis of the proximal vertebral artery for < 50% stenosis were PSVorigin >= 85 cm/s, PSVorigin /PSVIV >= 1.3, and end-diastolic velocity at the origin >= 27 cm/s; for 50-69% stenosis were PSVorigin >= 140 cm/s, PSVorigin/PSVIV >= 2.1, and end-diastolic velocity at the origin >= 35 cm/s; and for 70-99% stenosis were PSVorigin >= 210 cm/s, PSVorigin/PSVIV >= 4.0, and end-diastolic velocity at the origin >= 50 cm/s. PSVorigin was the most useful hemodynamic parameter, having accuracy of 94.5%, 96.2%, and 88.7% for the diagnosis of < 50%, 50-69%, and 70-99% stenosis.CONCLUSION. Color Doppler imaging is a reliable method for evaluation of vertebral artery stenosis. The results derived from this study can be used as a reference for establishing sonographic criteria for proximal vertebral artery stenosis.