经颅多普勒对颅内动脉狭窄诊断的临床应用  

The Clinical Application of TCD in the Diagnosis of Intracranial Arterial Stenoses

作　　者：袁丰莲[1] 

机构地区：[1]临沂市人民医院脑电图室,山东临沂276001

出　　处：《中国康复》2007年第4期247-248,共2页Chinese Journal of Rehabilitation

摘　　要：目的:探讨颅内动脉狭窄经颅多普勒(TCD)检测特点,筛选对于诊断有价值的检测指标。方法:TCD检测86例缺血性脑血管病(ICVD)患者收缩期峰流速(Vp)、舒张末期流速(Vd)、平均血流速度(Vm)、阻力指数(RI)及脉动指数(PI),着重对血管反应性进行观察。结果:86例患者颅内动脉狭窄为中轻度31例,中度17例,重度12例,大脑中动脉闭塞5例,共计65例为颅内动脉狭窄组(狭窄组),无动脉狭窄21例为无狭窄组。狭窄组患者大脑中及前动脉血管反应性明显低于非狭窄组(P<0.05);轻、中度患者Vp、Vd、Vm、RI及PI与非狭窄组比较无明显改变,重度患者则可见Vp低于非狭窄组(P<0.01)。结论:TCD是诊断颅内动脉狭窄的有效手段;与MRI及血管造影取长补短,可提高颅内动脉狭窄的诊断率,并可作为ICVD高发人群筛选工具。血管反应性是诊断颅内动脉狭窄的敏感指标,血流速度只能起参考作用,不能作为颅内动脉狭窄的诊断依据及分级标准。Objective： To study the characteristics of TCD in intracranjal artery stenoses and screen the valuable diagnosis indexes. Methods： Eighty-six cases of insufficiency cerebral vascular diseases were examined with TCD, and the detection indexes included： peak systolic velocity （Vp）, end diastolic peak velocity （Vd）, mean blood flow rate （Vm）, resistance index （RI）, pulsatility index （PI）. Vascular response was emphatically observed. The patients were divided into stenosis group （65 cases） and non-stenosis group （21 cases） according to the results from TCD. Results： In 86 cases detected by TCD, there were 31 cases of mild stenosis, 17 cases of moderate stenosis and 12 cases of severe stenosis, and 5 cases of MCA occlusion. In the stenosis group, the vascular responses of MCA and ACA were significantly decreased as compared with non-stenosis group （P〈0.05）. There was no significant difference in Vp, Vd, Vm, RI and PI in mild cases and moderate cases between stenosis group and non-stenosis group, but in severe cases, the Vp in stenosis group was lower than that in non-stenosis group（P〈0.01）. Conclusion： TCD is a valuable means in diagnosing intracranial artery stenosis. Vascular response is a sensitive index. The indexes of blood flow can not be used as diagnostic and grading criterion.

关 键 词：经颅多普勒 颅内动脉 血管反应性 

分 类 号：R445.1[医药卫生—影像医学与核医学]