Ultrasound Diagnosis Of Intracranial Stenosis And Stenosis Of The Internal Carotid Artery Atherosclerotic

PartⅠ:Exploration of the Value of Color Doppler Flowing Imaging with the Three Kinds of Standards in Assessing the Degree of the Inter Carotid Artery AtheroscleroticObjective: To analyze the sensitivity, specificity of three color Doppler(CDFI) parameters standard for the diagnosis of carotid artery(ICA) stenosis degree, and provide theoretical basis for objective assessment of three parameters standard.Methods: 73 cases undergone carotid artery color doppler ultrasound examination and suspected with ICA stenosis were chosen from september 2013 to November 2015 in The First Affiliated Hospital of Lanzhou University, Lanzhou General Hospital of Lanzhou Military Area Command and Gansu Provincial People’s Hospital ICA stenosis degree of all cases were assessed using three CDFI parameters standard respectively, analyze the diagnostic value of three parameters standard for the ICAS according to the results of whole brain DSA.Results: comparative analysis of three vascular stenosis evaluation standard and international recognition DSA, there was significant difference among the three examination standard via consistency test analysis of all examinee(P < 0.01);the final evaluation results of three examination standard were in good agreement with gold standard, and three standard kappa value was 0.724、0.775、0.570 respectively, it can be concluded that the second examination standard results was closest to gold standard, thus, the second examination standard has the highest agreement with DSA(k=0.775).Conclusion: Three CDFI parameters standard can effectively evaluate ICA stenosis degree, Australian standard moderate and severe diagnostic validity of the ICAS is better than the other two criteria. PartⅡ:The diagnostic value of CEUS for intracranial vascular stenosis diseasesObjective: To compare the diagnostic value of conventional transcranial ultrasound(TCD) and contrast enhanced transcranial ultrasound(CE-TCD) for intracranial vascular stenosis.Methods: 90 cases of acute ischemic cerebrovascular disease(ICVD) cases were collected from september 2013 to November 2015 in The First Affiliated Hospital of Lanzhou University, Lanzhou General Hospital of Lanzhou Military Area Command and Gansu Provincial People’s Hospital, observe the intracranial Willis circle, anterior cerebral artery, middle cerebral artery and vertebral basilar artery manifestation situation of TCD and CE-TCD, record and analyze the hemodynamic parameters before and after contrast enhancement.Results: 1. CE-TCD has higher efficiency than TCD for the examination of intralcranial vascular stenosis(P <0.05). 2. We can effectively obtain the hemodynamic parameters such as Vp, Vd, Vm and T in the course of CE-TCD examination, simultaneously, the accuracy of these parameters were significantly higher than TCD, there was no significant differences of all of these hemodynamic parameters before and after contrast enhancement by means of comparation left and right vertebral artery blood flow parameters(P> 0.05). 3. The diagnostic consistency is poor between TCD and CTA(Kappa=0.119,P<0.05), while the CE-TCD diagnostic results were in good agreement with the CTA(Kappa=0.668,P<0.05).Conclusion: CE-TCD can significantly increase the manifestation rate of intracranial artery compare with TCD, improve the accuracy of intracranial artery stenosis degree assessment, and has good agreement with the CTA.