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| Value of TCD Combined with Serum D-D in Diagnosis of Intracranial Artery Stenosis in Acute Cerebral Infarction |
| XU Ping, TANG Yan-yan, ZHANG Long |
| Shanghai Baoshan District Luodian Hospital,Shanghai 201901 China |
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Abstract 【Objective】 To investigate the diagnostic value of transcranial Doppler sonography (TCD) combined with serum D-dimer (D-D) in the diagnosis of intracranial artery stenosis in acute cerebral infarction. 【Methods】 A total of 112 patients with acute cerebral infarction admitted to our hospital from July 2018 to July 2020 were selected as the research subjects. All patients received CT angiography (CTA) and TCD examination, and venous blood was drawn to detect the serum D-D level. The results of TCD and CTA in detecting intracranial artery stenosis were compared. Using CTA results as the gold standard, the diagnostic value of TCD on intracranial vascular stenosis was analyzed, and receiver operating characteristic curve (ROC) was used to analyze the diagnostic value of serum D-D in the diagnosis of intracranial vascular stenosis, and the area under the curve (AUC) was recorded. The value of TCD combined with serum D-D in the diagnosis of intracranial vascular stenosis was compared with single detection. 【Results】 CTA examination results showed that among 112 patients, there were 81 cases of intracranial vascular stenosis and 31 cases of non-stenosis. Overall, 202 stenotic vessels were detected by CTA and 191 stenotic vessels were detected by TCD. TCD had a good consistency in the diagnosis of stenotic vessels, with Kappa value of 0.762. TCD had the highest diagnostic value on MCA vascular stenosis, with sensitivity of 91.76%, positive predictive value of 93.98% and the best consistency of Kappa value=0.852. ROC curve analysis results showed that the AUC value of serum D-D in the diagnosis of intracranial vascular stenosis was 0.714, and the diagnostic value was the highest when the cut-off point was>0.85mg/L, and the sensitivity and specificity were 48.15% and 87.10%, respectively. The sensitivity and accuracy of TCD combined with serum DD in the diagnosis of intracranial vascular stenosis were 93.83% and 95.54%, respectively, which were significantly higher than those of single detection of serum D-D (P<0.05), but there were no significant differences compared to single detection of TCD (P>0.05). 【Conclusion】 TCD has a high diagnostic value on intracranial artery stenosis in acute cerebral infarction, especially for MCA vascular stenosis. TCD combined with serum D-D can improve the diagnostic accuracy.
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Received: 10 December 2020
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2021, Vol. 38 
