本研究中不同程度動(dòng)脈狹窄時(shí),諧波造影的狹窄率與DSA符合率均高于其它超聲方法,并且其kappa值最大,這些優(yōu)點(diǎn)在>75%組更為明顯,原因是諧波造影時(shí)基礎(chǔ)狀態(tài)下發(fā)射功率低,血管周?chē)M織的圖像全部被減影,可獲得類(lèi)似DSA的動(dòng)脈影像,因此能更直觀更清晰地再現(xiàn)流道輪廓,偽像少,易于狹窄處內(nèi)膜邊界的識(shí)別. 常規(guī)超聲顯示比較困難的脛腓干動(dòng)脈在應(yīng)用造影劑后可使病變段更好地顯示,敏感性和特異性均明顯提高[7]. Ubbink等[8]對(duì)14例常規(guī)超聲顯示不清的下肢動(dòng)脈用Sono Vue進(jìn)行造影,造影后的診斷信心由56%提高到91%,對(duì)動(dòng)脈閉塞的診斷特異性達(dá)100%. Eiberg等[9]對(duì)37條常規(guī)超聲診斷不明確的血管,超聲造影后明確診斷的26條血管中有19條改變了原來(lái)常規(guī)超聲的診斷結(jié)果,并經(jīng)DSA證實(shí). 因此,超聲造影在診斷外周動(dòng)脈疾病方面的應(yīng)用有很廣闊的前景.
綜上所述,我們通過(guò)對(duì)比超聲造影與常規(guī)超聲觀察不同程度動(dòng)脈狹窄時(shí)發(fā)現(xiàn),高頻探頭結(jié)合諧波造影能清晰顯示血管腔輪廓, 其狹窄率測(cè)定的準(zhǔn)確度可與傳統(tǒng)的DSA相媲美,是檢查動(dòng)脈狹窄性疾病的可靠手段,尤其適用于無(wú)創(chuàng)隨訪.
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