河北医科大学学报

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经颅彩色多普勒超声、磁共振血管成像对单侧大脑中动脉狭窄筛查诊断价值的ROC曲线分析

  

  1. 1.河北省保定市第一中心医院超声科，河北 保定 071000；2.河北省保定市第一中心医院CT/MRI室，河北 保定 071000；3.河北省保定市第七医院超声科，河北 保定 072150
  • 出版日期:2018-05-25 发布日期:2018-05-30
  • 作者简介:王峥(1981-)，男，河北保定人，河北省保定市第一中心医院主治医师，医学硕士，从事医学超声诊断研究。
  • 基金资助:
    保定市科学技术研究与发展指导计划（17ZF046）

Transcranial colorcoded sonography and magnetic resonance angiography in screening of diagnosing unilateral middle cerebral artery stenosis: ROC curve analysis#br#

  1. 1.Department of Ultrasonography, the First Center Hospitol of Baoding, Hebei Province, Baoding
    071000, China； 2.Department of CT/MRI, the First Center Hospitol of Baoding, Hebei Province,
    Baoding 071000, China； 3.Department of Ultrasonography, the seven Hospitol of
    Baoding, Hebei Province, Baoding 072150, China
  • Online:2018-05-25 Published:2018-05-30

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摘要： ［摘要］〓〖HJ1.77mm〗
〖HTH〗目的〖HTSS〗〖KG*2〗通过受试者工作特征（receiver operating characteristic,ROC）曲线分析评估经颅彩色多普勒超声(transcranial colorcoded sonography,TCCS)和磁共振血管成像（magnetic resonance angiography,MRA）对于单侧大脑中动脉（middle cerebral artery,MCA）狭窄的诊断价值。
〖HTH〗方法〖HTSS〗〖KG*2〗选取行TCCS、MRA及头颈部CT血管成像（CT angiography,CTA）3种检查方法的单侧MCA狭窄患者127例，以CTA检查结果为标准，其中137根正常MCA，117根狭窄者，按程度分为正常、轻度狭窄、中度狭窄及重度狭窄，然后进行ROC曲线分析。
〖HTH〗结果〖HTSS〗〖KG*2〗TCCS与MRA在诊断单侧MCA狭窄的曲线下面积分别为0.989（95%CI 0.967~0.998）、0.991（95%CI 0.970~0.999），差异无统计学意义（P＞005）；在诊断单侧MCA轻度-中度狭窄的曲线下面积分别为0.959（95%CI 0.796~0.941）、0.882（95%CI 0.894~0.989），MRI诊断价值高于TCCS，差异有统计学意义（P＜005）；在诊断单侧MCA中度-重度狭窄的曲线下面积分别为0.939（95%CI 0.847~0.984）、0.955（95%CI 0.868~0.991），差异无统计学意义（P＞005）。
〖HTH〗结论〖HTSS〗〖KG*2〗TCCS和MRA 2种检查作为筛查单侧MCA狭窄方法均具有较高的诊断价值，尤其在诊断轻度-中度狭窄分级上，MRA诊断价值高于TCCS。

关键词: 大脑中动脉狭窄, 超声检查, 多普勒, 彩色, 磁共振成像

Abstract: ［Abstract］〓Objective〖HTSS〗〓To evaluate transcranial colorcoded sonography(TCCS) and magnetic resonance angiography(MRA) in screening of diagnosing unilateral middle cerebral artery(MCA) stenosis by using receiver operating characteristic(ROC) curve analysis. 
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 127 patients with unilateral middle cerebral artery(MCA) stenosis were enrolled in this study. TCCS, MRA and CT angiography(CTA) of head and neck were performed in all patients. Based on CTA results,137 normal MCA of root in the control group, 117 MCA with stenosis were divided into 4 categories: normal, mild stenosis, moderate stenosis and severe stenosis, then the data were evaluated using ROC curve analysis.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The two diagnostic methods of TCCS and MRA were of high value in the diagnosis of stenosis in the unilateral MCA. The area under the curve of TCCS and MRA were 0.989(95%CI 0.967-0.998) and 0.991(95%CI 0.970-0.999), and the area under the curve was not statistically significant(P＞005).The diagnostic value of MRI was higher than that of TCCS in the diagnosis of mild to moderate stenosis in the unilateral MCA. The area under the curve was 0.959(95%CI 0.796-0.941) and 0.882(95%CI 0.894-0.989) respectively, and the area under the curve was statistically different(P＜005). In the diagnosis of moderate to severe stenosis, both methods have high value, and the area under the curve is 0.939(95%CI 0.847-0.984) and 0.955(95%CI 0.868-0.991) respectively, and the area under the curve is not statistically significant(P＞005). 
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Both TCCS and MRA tests have high diagnostic value as a method for screening the arterial stenosis in the unilateral MCA, especially in the diagnosis of mild to moderate stenosis, the diagnostic value of MRA is higher than that of TCCS.

Key words: middle cerebral artery stenosis, ultrasonography, Doppler, color； magnetic resonance imaging

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