颅外段椎动脉狭窄经皮血管内成形术及内支架治疗前后彩色多普勒超声检查的临床价值  

Clinical value of color doppler ultrasonography to extracranial vertebral artery stenosis before and after percutaneous transluminal angioplasty and stent treatment

作　　者：吴亮[1] 杨顺实[1] 张临洪[2] 江玲[1] 李晶晶[1] 田冬荣[1] 

机构地区：[1]武汉市中心医院超声影像科,430014 [2]武汉市中心医院神经内科,430014

出　　处：《临床神经病学杂志》2009年第5期347-349,共3页Journal of Clinical Neurology

摘　　要：目的研究颅外段椎动脉狭窄患者经皮血管内成形术及内支架(PTAS)治疗前后,彩色多普勒超声检查的临床价值。方法对61例经数字减影血管造影(DSA)检查确诊的颅外段椎动脉狭窄患者,于PTAS治疗前和治疗后3 d、30 d,用彩色多普勒超声仪(CDU)检测患者双侧颅外段椎动脉,取C5-C6段和狭窄处椎动脉峰值流速(PSV)和阻力指数(RI)、血流量(FV)为分析指标。结果本组患者PTAS治疗前,CDU检查示颅外段椎动脉狭窄80条(轻度17条,中度38条,重度25条),与DSA检查结果相比较,符合率86.9%(77.3%,95.0%,83.3%),其中CDU检查中度颅外段椎动脉狭窄符合率较高(P<0.01)。颅外段椎动脉狭窄患者PTAS治疗后3 d与治疗前比较,患侧椎动脉C5-C6段PSV和FV显著升高(均P<0.01),椎动脉狭窄处PSV显著降低(P<0.01),治疗后30 d与3 d比较,各项指标的差异无统计学意义(均P>0.05)。结论CDU检查对颅外段椎动脉狭窄的诊断有重要价值,能反映PTAS治疗后颅外段椎动脉血流动力学的变化,提供了一种PTAS治疗后观察疗效的方法。Objective To investigate the clinical value of color doppler uhrasonography （CDU） to extracranial vertebral artery stenosis before and after percutaneous transluminal angioplasty and stcnt（PTAS） treatment. Methods 61 patients with extracranial vertebral artery stenosis confirmed by digital subtraction angiography （DSA） were detected by CDU on both sides of extracranial vertebral artery before and 3 d, 30 d after PTAS. The flow volume （FV）, peak systolic velocity （PSV） and resistance index （RI） at the site of C5-C6 segment and stenosis were as analysis targets. Results Before PTAS, 80 stenotic extracranial vertebral arteries were found by CDU（ mild degree 17 cases,moderate degree 38 cases,severe degree 25 cases）. Compared with DSA, coincidence was 86.9% （77.3%, 95.0% ,83.3% ）. Among them, the coincidence of moderate extracranial vertebral artery stenosis detected by CDU was excellent （P〈 0.01 ）. Compared with before PTAS, PSV and FV at vertebral artery C5-C6 segment were significantly higher at 3 d after PTAS （ all P 〈 0.01 ） , but PSV at vertebral artery stenosis was significantly lower （ P 〈 0.01 ） , while all analysis targets had no significant difference between 30 d and 3 d after PTAS （ all P 〉 0.05 ）. Conclusion CDU has the important value in diagnosing extracranial vertebral artery stenosis, and can be used to follow up the blood hemodynamics in the extracranial vertebral artery of patients treated by PTAS. It provided a method for observing the efficacy of PTAS treatment.

关 键 词：椎动脉狭窄 经皮血管内成形术及内支架 彩色多普勒超声 数字减影血管造影 

分 类 号：R743[医药卫生—神经病学与精神病学]