颈动脉超声和经颅多普勒超声联合评价颈动脉狭窄支架治疗的临床价值  

Clinical value of the combination of carotid artery ultrasound and TCD in the evaluation of carotid artery stenosis stenting

作　　者：王洪科[1] 张小宁[1] 刘培琴[2] 周君[1] 张晓光[3] 

机构地区：[1]新疆医科大学第一附属医院神经内科,乌鲁木齐830054 [2]新疆医科大学第一附属医院心脏超声诊断科经颅多普勒室 [3]新疆医科大学第一附属医院超声医学中心

出　　处：《中国神经精神疾病杂志》2014年第1期31-34,共4页Chinese Journal of Nervous and Mental Diseases

基　　金：国家自然科学基金项目(编号:81160145)资助

摘　　要：目的采用颈动脉超声(carotid artery ultrasound)和经颅多普勒超声(transcranial doppler,TCD)技术联合评价和随访颈动脉狭窄患者行颈动脉支架置入术(carotid artery stenting,CAS)的治疗效果。方法回顾分析经全脑血管造影(digital subtraction angiography,DSA)确诊具有脑缺血症状的颈动脉狭窄且接受颈动脉支架置入术治疗的患者71例,采用颈动脉超声联合经颅多普勒超声测量颈动脉支架置入术治疗前、后颈动脉狭窄局部管径、狭窄段收缩期峰值流速(peak systolic velocity,PSV)及同侧大脑中动脉(middle cerebral artery,MCA)的PSV、搏动指数(pulsatility index,PI),并进行对比分析。结果颈动脉狭窄患者行颈动脉支架置入术后原狭窄处内径由术前(3.13±0.83)mm增加至术后1周的(4.77±0.51)mm(P<0.05)、术后1年的(4.64±0.52)mm(P<0.05);颈动脉狭窄处PSV由术前(190.69±113.65)cm/s,降至术后1周的(86.15±30.52)cm/s(P<0.05)、术后1年的(90.28±29.79)cm/s(P<0.05);患侧MCA的PSV由术前(77.68±14.66)cm/s,术后1周升高为(115.62±22.32)cm/s(P<0.05),术后1年升高为(108.89±20.29)cm/s(P<0.05),PI值由术前(0.81±0.01),术后1周提高到(1.07±0.01)(P<0.05)、术后1年提高到(1.06±0.02)(P<0.05)。结论颈动脉超声和经颅多普勒超声检测结果提示颈动脉支架置入术后,颈动脉血管内径及脑血流动力学有明显改善,颈动脉超声和经颅多普勒超声联合可以作为准确评价和随访颈动脉支架置入术疗效的有效手段。Objective In order to examine the value of the combination of carotid artery ultrasound and Transcrani-al Doppler （TCD） in the evaluation of carotid artery stenosis stenting. Methods Seventy-one carotid stenosis cases con-firmed by digital subtraction angiography （DSA） who had cerebral isehemia symptoms and received stent implantation were reviewed. Carotid artery ultrasound and TCD were adopted to measure the vessel diameter, peak systolic velocity （PSV） of the narrow segment, PSV and pulsatility index （PI） of ipsilateral middle cerebral artery （MCA） before and after the treatment of intravascular stents, and a comparison analysis was made. Results Carotid stent implantation significant- ly improved the inner diameter, PSV of the narrow part, PSV and PI of the MCA on the stenotic side. Inner diameter of the narrow part was 3.13±0.83, 4.77±0.51 and 4.64±0.52 mm at before, one week and one year after the implantation, re-speetively （P 〈0.05）. The PSV of the narrow part was 190.69±113.65, 86.15±30.52 and 90.28±29.79 cm/s at before, one week and one year after the implantation, respectively （P 〈0.05）.PSV of the MCA on the stenotic side was 77.68± 14.66, 115.62±22.32 and 108.89±20.29 crn/s at before, one week and one year after the implantation, respectively （P 〈0.05）. PI of the MCA on the stenotic side was 0.81±0.01, 1.07±0.01 and 1.06±0.02 at before, one week and one year after the implantation, respectively （P 〈0.05 ）. Conclusions The present study demonstrates that the combination of carotid artery ultrasound and TCD can quantitatively detect the vascular structural and hemodynamie improvements following the endo- vascular stenting, indicating that the combination of carotid artery ultrasound and TCD can be used for the accurate as-sessment and follow up of carotid artery stenting treatment.

关 键 词：颈动脉狭窄 颈动脉超声 经颅多普勒超声 

分 类 号：R743.3[医药卫生—神经病学与精神病学]