关键词: 梗死, 大脑中动脉, 超声检查, 多普勒, 经颅, 血流速度

Abstract: ［Abstract］ Objective〖HTSS〗〓To evaluate the stenosis and classification of the middle cerebral artery(middle cerebral artery, MCA), and the value of transcranial colorcoded sonography(TCCS) in the middle cerebral artery stenosis by using TCCS and computed tomography angiography as diagnostic criteria.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The TCCS examination was performed in our hospital to record the MCA color doppler beam performance, the peak systolic velocity(PSV), enddiastolic velocity(EDV), and mean flow velocity(MFV). There are 127 cases with 254 blood vessels with result suggesting unilateral MCA stenosis and performed CTA examination. MCA was classified into 4 groups: normal, mild, moderate, and severe.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓PSV, EDV and MFV were all higher in the narrow group than the flow velocity values of the normal group, and the differences were statistically significant(P＜005).Compared with the normal group, the flow rate of each subgroup in the narrow group was higher, that is, the flow rate was increased gradually with the severity of stenosis, and the difference was statistically significant(P＜005). Followed are the positive cutoff values of 95%CI for stenosis degree under the ROC curve. The best cutoff points of normal and narrow positive boundary values were PSV 143 cm/s, EDV 65 cm/s, and MFV 86 cm/s. Most balanced with PSV, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 95%CI. The best cutoff points of mild and moderate stenosis were PSV 174 cm/s, EDV 73 cm/s and MFV 109 cm/s respectively. Most balanced with PSV, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 95%CI. The best cutoff points of moderate and severe stenosis were PSV 227 cm/s, EDV 116 cm/s, MFV 147 cm/s. Most balanced with PSV, its sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 95%CI. With PSV, EDV and MFV as the standard of evaluating MCA stenosis, the consistency with CTA was examined. CTA results with PSV has the highest accuracy(Kappa value=0.805,  the consistency is the best), followed by the consistency of CTA results with MFV(Kappa value=0.695, the consistency is quite good), with the consistency of CTA results and EDV taking the third place(Kappa value=0.599, the consistency is good).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓TCCS evaluation of MCA stenosis has high value.

Key words: infartion, middle cerebral artery, ultrasonography, Doppler, transcranial, blood flow rate