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目的探讨DSA(数字减影血管造影)、TCD(经颅多普勒超声)分别在颅内血管狭窄诊断准确性上的差异。方法将200例可疑颅内血管狭窄患者分别行DSA和TCD检查,以病理确诊为标准,比较DSA和TCD诊断颅内血管狭窄的灵敏度、特异度、阳性预测值及阴性预测值。分析DSA和TCD诊断准确性的差异。结果 200例患者经病理切片确诊共174例,经DSA检测出阳性151例,真阳性148例;经TCD检测出阳性103例,真阳性92例,以病理诊断为标准,计算出DSA的灵敏度、特异度、阳性预测值及阴性预测值分别为85.06%、88.46%、98.01%和46.94%;均高于TCD的52.87%、57.69%、89.32%和15.46%(P<0.05)。结论 DSA诊断颅内血管狭窄较TCD有更高的准确率,TCD可作为DSA检查的筛选手段。
Objective To investigate the differences of diagnostic accuracy between DSA (digital subtraction angiography) and TCD (transcranial Doppler ultrasound) in the diagnosis of intracranial vascular stenosis. Methods 200 patients with suspected intracranial stenosis were examined by DSA and TCD respectively. The pathological diagnosis was used as the standard. The sensitivity, specificity, positive predictive value and negative predictive value of DSA and TCD were compared. Analyze the differences in the diagnostic accuracy of DSA and TCD. Results A total of 174 cases were confirmed by biopsy in the 200 cases. 151 cases were positive and 148 cases were true positive by DSA. 103 cases were positive by TCD and 92 cases were true positive. The sensitivity of DSA was calculated by pathological diagnosis. The specificity, positive predictive value and negative predictive value were 85.06%, 88.46%, 98.01% and 46.94% respectively, which were all higher than those of TCD (52.87%, 57.69%, 89.32% and 15.46%, P <0.05). Conclusion DSA has a higher accuracy in diagnosing intracranial vascular stenosis than TCD, and TCD can be used as a screening method for DSA.