椎动脉颅内段血流速度及频谱波形异常的分析与诊断  

Analysis and Diagnosis of Abnormal Flow Velocity and Spectralvien of Intracranial Vertebral Artery

作　　者：张雄伟[1] 刘建红 张以善[1] 王开平[1] 李曼[1] 王翠玉[1] 史杰[1] 

机构地区：[1]解放军第二炮兵总医院神经内科,北京100088 [2]解放军第二炮兵礼士路门诊部,北京100820

出　　处：《实用临床医药杂志》2008年第2期45-47,共3页Journal of Clinical Medicine in Practice

摘　　要：目的探讨椎动脉颅内段血流异常的类型、病变部位及产生原因。方法对299例经磁共振血管成像和/或数字减影血管造影证实的颅内外动脉严重狭窄或闭塞患者,采用经颅多普勒超声(TCD)和颈动脉连续波多普勒超声(CWD)评估椎动脉颅内段血流异常。结果299例患者共检测598支椎动脉颅内段,其中508支血流异常:狭窄血流(32支)、无血流(17支)、低流速低阻力(58支)、低流速高阻力(42支)、代偿血流(287支)和窃血频谱(72支)。狭窄血流或无血流均在病变部位直接检出,其他4种类型血流异常则是病变部位近端或远端动脉的间接血流改变。结论采用TCD和CWD评估椎动脉颅内段血流异常可为临床寻找后循环缺血的原因和更深入研究缺血性脑血管病的发病机制提供重要的客观依据。Objective To explore the pattern, lesion position and cause of abnormal blood flow of intracranial vertebral artery. Methods In 299 patients with severe stenosis or occlusion of intracranial or extracranial artery determined by MR angiography and/or digital subtraction, the ab- normal blood flow of intracranial vertebral artery was evaluated with transcranial Doppler （TCD） and cervical continuous-wave Doppler （CWD）. Results In 299 patients, 598 intracranial vertebral arteries were evaluated. Five hundred and eight arteries showed abnormal flow that manifested stenosis flow（32 arteries）, absent flow（ 17 arteries）, low velocity and pulsitility（58 arteries）, low velocity and high pulsitility（42 arteries）,compensatory flow（287 arteries） and steal spectral（72 arteries）. The stenosis flow or absent flow was discovered directly in lesion position. However, other 4 patterns of abnormal blood flow resulted from indirect flow change of proximal or distal artery of lesion position. Conclusions To evaluate the abnormal blood flow of intracranial vertebral artery with TCD and CWD might provide important and objective basis in discovering the cause of posterior circulation ischemia and in exploring deeply the pathogenesis of ischemic cerebrovascular disease.

关 键 词：椎动脉 超声检查 多普勒 经颅 连续波 血流动力学 侧支循环 锁骨下动脉窃血 

分 类 号：R445.1[医药卫生—影像医学与核医学]