Efficacy and Imaging Features of TCD Combined with Carotid Ultrasound in the Diagnosis of Posterior Circulation Ischemia in Patients with Carotid/Vertebral Atherosclerotic Plaque
Objective:To explore and analyze the efficacy and imaging features of transcranial Dopple(TCD)combined with carotid ultrasound(CAU)in the diagnosis of posterior circulation ischemia(PCI)in patients with carotid/vertebral atherosclerotic plaque.Method:A total of 80 patients with carotid/vertebral atherosclerotic plaque admitted to the Second Affiliated Hospital of Anhui University of Chinese Medicine from January 2021 to October 2023 were retrospectively selected.42 patients diagnosed with PCI were included in PCI group,and 38 patients without PCI were included in non-PCI group.Both groups were examined by TCD and CAU.TCD examination indexes[average blood flow velocity of vertebral artery(VA),posterior cerebral artery(PCA)and basilar artery(BA)],CAU examination indexes[plaque status,intima-media thickness(IMT),pulse index(PI)and resistance index(RI)]were compared between the two groups.At the same time,the results of CT angiography(CTA)taken as the"gold standard",the efficacy of TCD,CAU and their combination in diagnosing PCI in patients with carotid/vertebral atherosclerotic plaque were compared.Result:The average blood flow velocity of PCA,VA and BA in the PCI group were higher than those in the non-PCI group,the proportion of soft plaque was higher than that in the non-PCI group,and the IMT,PI and RI were higher than those in the non-PCI group,the differences were statistically significant(P＜0.05).The proportion of hard plaque in PCI group was significantly lower than that in non-PCI group,the difference was statistically significant(P＜0.05).The sensitivity of TCD examination in diagnosing PCI in patients with carotid/vertebral atherosclerotic plaque was 76.19%(32/42),the specificity was 92.11%(35/38),and the Kappa value was 0.677.The sensitivity of CAU examination in diagnosing PCI in patients with carotid/vertebral atherosclerotic plaque was 73.81%(31/42),the specificity was 89.47%(34/38),the accuracy was 81.25%(65/80),and the Kappa value was 0.627.The sensitivity of TCD combined with CAU examination in diagnosing PCI in patients with carotid/vertebral atherosclerotic plaque was 97.62%(41/42),the specificity was 89.47%(34/38),the accuracy was 93.75%(75/80),and the Kappa value was 0.874.The sensitivity,negative predictive value and accuracy of TCD combined with CAU in diagnosing PCI in patients with carotid/vertebral atherosclerotic plaque were higher than those of each single examination,the differences were statistically significant(P＜0.05).Conclusion:There are significant differences in hemodynamics,plaque status and vascular cyclic resistance in carotid/vertebral atherosclerotic plaque patients with PCI compared with non-PCI patients.TCD combined with CAU can effectively observe hemodynamic changes in patients with carotid/vertebral atherosclerotic plaque,and has high efficiency in diagnosing whether patients have PCI.
万方数据
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