Duplex ultrasound interpretation criteria for inferior mesenteric arteries
Duplex ultrasound interpretation criteria for inferior mesenteric arteries
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肠系膜下动脉的双功能超声解读标准
DOI：
10.1258/vasc.2011.oa0349
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发表时间：
2012
期刊：
影响因子：
1.1
通讯作者：
L. Scott Dean
中科院分区：
文献类型：
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作者：
A. AbuRahma;L. Scott Dean
对于肠系膜下动脉（IMA）狭窄的诊断，目前尚无特异性的双功超声（DUS）标准。本研究将定义在检测IMA ≥50%狭窄时具有最佳总体准确度（OA）的最佳多普勒速度值。分析了85例同时进行DUS和肠系膜动脉造影的IMA。共检查了85例IMA：血管造影显示45例正常，12例狭窄<50%，8例狭窄≥50-69%，15例狭窄≥70%（包括闭塞）。IMA正常、狭窄<50%和≥50%的平均收缩期峰值流速（PSV）分别为105、215和392 cm/s（P < 0.0001）。检测≥50%狭窄的最准确PSV为≥250 cm/s，灵敏度为90%，特异性为96%，OA为95%。检测≥50%狭窄的最准确舒张末期流速（EDV）为≥80%或≥90 cm/s，OA为86%，敏感性为60%，特异性为100%。受试者工作曲线分析显示，PSV检测≥ 50%狭窄的准确性并不优于EDV和PSV比值（P = 0.1661和0.4568）。总之，特定IMA PSV、EDV和IMA/主动脉收缩期比值可用于检测IMA显著狭窄，且准确性合理。
There is no specific duplex ultrasound (DUS) criteria for the diagnosis of inferior mesenteric artery (IMA) stenosis. This study will define the optimal duplex velocity values with the best overall accuracy (OA) in detecting ≥50% stenosis of the IMAs. Eighty-five IMAs with both DUS and mesenteric arteriography were analyzed. Eighty-five IMAs were examined: 45 were normal, 12 with <50% stenosis, eight with ≥50–69% stenosis and 15 with ≥70% stenosis (including occlusion) based on angiography. The mean peak systolic velocities (PSVs) for a normal IMA, <50% and ≥50% stenosis was 105, 215 and 392 cm/second, respectively (P < 0.0001). The most accurate PSV in detecting ≥50% stenosis was ≥250 cm/second with a sensitivity of 90%, a specificity of 96% and an OA of 95%. The most accurate end-diastolic velocity (EDV) in detecting ≥50% stenosis was ≥80% or ≥90 cm/second, with an OA of 86%, a sensitivity of 60% and a specificity of 100%. The most accurate ratio in detecting ≥50% stenosis was ≥4 or ≥4.5 with an OA of 93%.Receiver operator curves analysis showed that the PSV was not better than EDV and PSV ratio in detecting ≥50% stenosis (P = 0.1661 and 0.4568, respectively). In conclusion, specific IMA PSVs, EDVs and IMA/aortic systolic ratios can be used in detecting significant IMA stenosis with reasonable accuracy.