在最大的缩加速和加速时间之间进行了诊断对比研究,以检测周围动脉疾病
Siem A Willems1, Obrecht O van Bennekom1, Abbey Schepers1
1Department of Vascular Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Annals of vascular surgery
|November 25, 2024
概括
最大缩加速 (ACCmax) 比加速时间 (AT) 更准确地检测周围动脉疾病 (PAD),特别是在糖尿病或慢性病患者中. 在诊断PAD时,应优先考虑ACCmax.
科学领域:
- 血管医学 血管医学
- 诊断成像 诊断成像 诊断成像
- 超声波技术 超声波技术 超声波技术
背景情况:
- 在患有糖尿病 (DM) 或慢性病 (CKD) 的患者中,由于中枢动脉化 (MAC),检测周围动脉疾病 (PAD) 是具有挑战性的.
- 传统的床边测试,如脚腕指数,在这些特定的患者群体中降低了准确性.
- 护理点双重超声波为PAD评估提供了一个潜在的替代方案.
研究的目的:
- 为了评估 point-of-care双重超声波参数的诊断准确性:最大缩加速度 (ACCmax) 和加速度时间 (AT).
- 为了比较ACCmax和AT在检测PAD的诊断性能.
- 为了评估中枢动脉化 (MAC) 或没有中枢动脉化 (MAC) 的患者的精度.
主要方法:
- 包括疑似PAD的患者,接受了骨动脉的双重超声检查 (ACCmax,AT) 和计算机断层扫描血管学 (CTA).
- PAD定义为>50%的CTA上的狭窄;AT的诊断准确性通过在各种切线处的灵敏度,特异性和概率比率进行评估.
- 使用McNemar测试比较ACCmax和AT,对易患MAC (DM和/或CKD) 的患者进行亚组分析.
主要成果:
- 在检测PAD时,ACCmax表现出比AT更高的诊断准确性,用于后关动脉 (PTA) 和前关动脉 (ATA).
- 这种优势在容易发生中枢动脉化 (MAC) 的患者中是一致的.
- 在ACCmax和AT之间没有观察到它们排除PAD能力的显著差异.
结论:
- 最大缩加速 (ACCmax) 是一个比加速时间 (AT) 更准确的参数,用于诊断PAD,包括患有DM或CKD的患者.
- 在怀疑PAD的诊断工作中,ACCmax应该是首选的参数,因为它能够更好地检测动脉狭窄.
- 这两个参数都在排除PAD时表现出类似的准确性.
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