经颅多普勒超声对后循环缺血的诊断价值  

Transcranial Doppler Ultrasound for the Diagnosis of Posterior Circulation Ischemia

作　　者：刘炳奇[1] 刘南平[2] 陈景云[2] 潘宗[2] 

机构地区：[1]宁夏医科大学,银川750004 [2]宁夏医科大学心脑血管病医院,银川750004

出　　处：《宁夏医科大学学报》2014年第7期768-771,共4页Journal of Ningxia Medical University

摘　　要：目的观察后循环缺血(PCI)的血流动力学、声频和频谱形态变化,探讨经颅多普勒超声(TCD)在后循环缺血中的诊断价值。方法 TCD检测PCI组、健康组颅内动脉血管,记录双侧大脑后动脉(PCA)、双侧椎动脉(VA)、基底动脉(BA)的峰值血流速度(Vs)、平均血流速度(Vm)、舒张末期血流速度(Vd)并观察频谱形态变化及动脉搏动指数(PI),对两组检测结果做对比性分析。结果 (1)PCI组共检测血管600条,其中BA 120条,VA 240条,PCA 240条,TCD检测发现管腔闭塞5条、轻度狭窄43条、中度狭窄15条、重度狭窄2条,其中VA38条、BA17条、PCA10条;(2)锁骨下动脉盗血综合征(SSS)2例,另有三例存在后交通动脉开放;(3)PCI组与健康组的BA及双侧PCA、VA的PI值比较差异均有统计学意义(P<0.05);PCI组与健康组的BA及右侧VA的Vs值比较差异均有统计学意义(P<0.05);PCI组与健康组的双侧PCA的Vd值比较差异均有统计学意义(P<0.05);(4)以健康组峰值血流速度为参照:PCI组血流速度增高的123条(20.5%)、血流速度减慢的203条(33.8%),血流速度异常检出率54.3%(326/600)。结论 PCI患者狭窄或闭塞部位多位于椎动脉和基底动脉,后循环动脉PI值多异常增高;TCD检测方法无创、可动态重复、简便易行,是临床作为PCI患者筛查的首选方法。Objective To observe hemodynamic, audio and spectral shape in posterior circulation ischemia （PCI）, and to explore the diagnostic value of the transcranial Doppler （TCD） in the posterior circulation is- chemia. Methods Intracranial arteries were detected by TCD in PCI gioup, and healthy group. Cerebral ar- tery （ PCA）, bilateral vertebral artery （ VA）, basilar artery （BA） systol： cvelocity （ Vs）, meanveloeity （ Vm）, diastolic velocity（Vd） and morphological changes were recorded. Spectrum changes and artery pulsatility in- dex （PI） were observed. Results （1） 600 vessels were were detected in PCI group in which BA 120, VA 240 and PCA 240 while in TCD group the results showed that obliteration 5, mild stenosis 43, 15 moderate stenosis, severe stenosis 2; （2） the subclavian steal syndrome （SSS） were found in 2 cases and traffic arter- ies open was found in 3 cases ; （3） difference of BA, bilateral PCA, PI value between PCI group and healthy group had statistical significance （P 〈 0.05 ）. Difference of BA and the VA Vs value on the right side between PCI group and healthy group had statistical significance （P 〈 0.05 ） ; difference of bilateral PCA Vd value be- tween PCI group and healthy group had statistical significance （P 〈 0. 05） ; （4） peak blood flow velocity in healthy group as reference： PCI group increased blood flow velocity of 123 （ 123/600 ;20.5% ）, blood flow at a slower pace of article 203 （203/600; 33.8% ）, blood flow velocity anomaly detection rate 54.3% （326/ 600）. Conclusion Most of the patients with posterior circulation isch.~mia stenosis or occlusion were in the vertebral artery and basilar artery. TCD noninvasive detection method is the preferred method of screening pa- tients with PCI.

关 键 词：后循环缺血 经颅多普勒超声 血流参数 血流频谱形态 

分 类 号：R445.1[医药卫生—影像医学与核医学]