经颅多普勒超声诊断脑动脉痉挛与数字减影血管造影的对比研究  

Comparative study on transcranial doppler and digital subtraction angiography in detection of cerebral arterial spasm

作　　者：曹音[1] 钱惠农[2] 刘志平[3] 陈芷若[4] 

机构地区：[1]南京医科大学附属常州市第二人民医院神经内科,常州213003 [2]南京医科大学附属常州市第二人民医院神经外科,常州213003 [3]南京医科大学附属常州市第二人民医院脑超室,常州213003 [4]南京医科大学附属脑科医院

出　　处：《临床神经病学杂志》2004年第3期169-171,共3页Journal of Clinical Neurology

基　　金：南京医科大学科技发展基金资助 (NY0 2 0 4 5)

摘　　要：目的　探讨经颅多普勒超声 (TCD)诊断大脑中动脉 (MCA)、椎动脉 (VA)、基底动脉 (BA)痉挛的可靠性。方法　对 5 0例蛛网膜下腔出血患者同时行TCD和数字减影血管造影 (DSA)检查并进行对比分析。结果　DSA发现MCA痉挛 2 6条 ,其中TCD检出 2 1条 ,DSA未证实有痉挛的MCA中 ,TCD检出 4条 ,TCD诊断MCA痉挛的敏感性为 80 8% ,特异性为 84 0 % ,而且MCA痉挛程度越重 ,TCD敏感性越高。DSA发现BA痉挛18条 ,其中经TCD检出 13条 ,DSA未证实有痉挛的BA中 ,TCD检出 4条 ,TCD诊断BA痉挛的敏感性为72 2 % ,特异性为 76 5 %。DSA发现VA痉挛 2 8条 ,其中经TCD检出 2 0条 ,DSA未证实有痉挛的VA中 ,TCD检出 6条 ,TCD诊断VA痉挛的敏感性为 71 4 % ,特异性为 76 9%。结论　TCD诊断MCA、VA、BA痉挛有较高的可靠性。Objective To evaluate the reliability of transcranial doppler (TCD) in detection spasm of middle cerebral artery (MCA),vertebral artery (VA ) and basilar artery (BA).Methods TCD and digital subtraction angiography (DSA) examination were undertaken in 50 patients with subarachnoid hemorrhage.Results Arterial spasm was diagnosed in 26 MCA by DSA,21 of which were detected by TCD at same time.4 MCA were showed by TCD but not confirmed by DSA. The sensitivity and specificity of TCD in diagnosing MCA spasm were 80.8% and 84.0% respectively. Higher sensitivity was revealed in those with severe MCA spasm. DSA also found out asterial spasm of BA in 18 BA,among which 13 arteries were detected by TCD simutaneously.4 BA were diagnosed by TCD but not proved by DSA. The sensitivity and the specificity of TCD in diagnosing BA spasm were 72.2% and 76.5% respectively.28 VA were diagnosed by DSA,among which 20 arteries were proved by TCD.6 VA were detected by TCD but not proved by DSA. The sensitivity and specificity of TCD in diagnosing VA spasm were 71.4% and 76.9% respectively.Conclusion TCD is reliable in diagnosing the spasm of MCA,BA and VA.

关 键 词：经颅多普勒超声 数字减影血管造影 脑动脉痉挛 

分 类 号：R743.3[医药卫生—神经病学与精神病学]