超声对颈内动脉严重狭窄或闭塞时颅内侧支循环情况的评价  

Ultrasonography in evaluation of intracerebral collateral circulation with severe stenosis or obstructive internal carotid artery

作　　者：姥义[1] 赵宝珍[1] 柳标[1] 周智慧[1] 孙秀英[1] 

机构地区：[1]第二军医大学长海医院超声科,上海200433

出　　处：《中国医学影像技术》2006年第5期711-714,共4页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金资助(30370401)

摘　　要：目的应用经颅彩色双功超声(TCCS)评价颈内动脉严重狭窄或闭塞时颅内侧支循环的建立情况。方法采用彩色多普勒血流成像筛选单侧颈内动脉严重狭窄或闭塞的患者,用TCCS检测颅内主要动脉的血流动力学变化。结果①有前交通动脉参与的侧支循环与中风发生呈负相关,而眼动脉(OA)参与的侧支循环与中风发生呈正相关。②无症状组及有症状组颈内动脉严重狭窄或闭塞的患者患侧大脑中动脉(MCA)的收缩期峰值流速、搏动指数明显低于健侧及对照组。无症状组患侧OA的收缩期峰值流速、搏动指数与健侧及对照组比较无统计学意义,而有症状组OA的收缩期峰值流速、搏动指数明显低于健侧及对照组。结论TCCS检测颅内主要动脉的血流动力学变化,可以方便地评价颅内侧支循环状态,对颈内动脉严重狭窄或闭塞患者治疗和预后的判断具有重要的临床价值。Objective To evaluate intracerebral collateral circulation with unilateral severe stenosis or obstructive extracranial internal carotid artery by transcranial color-coded duplex sonography （TCCS）. Methods Color Doppler flow imaging was used to examine the patients with unilateral severe stenosis or obstructive extracranial internal carotid artery. TCCS was applied to detect the hemodynamic changes of the basal intracranial arteries. Results ①The opening of anterior communicating artery was in negative relation with the occurrence of stroke, while the opening of ophthalmic arteries （OA） was in positive relation. ②The peak systolic velocity and pulse index of ipsilateral middle cerebral arteries （MCA） in all patients and ipsilateral OA in symptomatic patients were significantly lower than those of contralateral MCA and normal control. However, the difference in the peak systolic velocity and pulse index of OA between the nonsymptomatic patients＂ stenosis side and contralateral side as well as normal control was not significant. Conclusion The examination of hemodynamic changes of the basal intracranial arteries by TCCS can determine the intracranial arterial collateral condition easily and is significant to evaluate severe stenosis or obstructive extracranial internal carotid artery.

关 键 词：超声检查 颈动脉狭窄 血流动力学 侧支循环 

分 类 号：R543.4[医药卫生—心血管疾病] R445.1[医药卫生—内科学]