TCD联合DSA在分水岭脑梗死颅内血管评价中的应用价值  

Value of transcranial Doppler combined with digital subtraction angiography in evaluation of intracranial vessels in patients with cerebral watershed infarction

作　　者：陶中海[1] 张清秀[1] 付家亮[1] 翟羽佳[1] 吕尤[1] 魏秀娥[1] 荣良群[1] 

机构地区：[1]徐州医学院第二附属医院神经内科,徐州221006

出　　处：《中华神经医学杂志》2015年第1期33-36,共4页Chinese Journal of Neuromedicine

摘　　要：目的探讨经颅多普勒（TCD）联合数字减影血管造影（DSA）在分水岭脑梗死颅内血管评价中的应用价值。方法对徐州医学院第二附属医院神经内科自2008年6月至2011年6月住院的97例分水岭脑梗死患者的临床及影像资料进行回顾性总结，分析TCD及DSA对该97例患者873条颅内血管的狭窄或闭塞及侧支循环代偿的诊断价值及两者的优缺点。结果TCD与DSA诊断颅内血管狭窄及闭塞方面差异无统计学意义（P=0．503）。在对侧支循环代偿评价方面，TCD及DSA诊断前交通动脉代偿差异无统计学意义（P=0．7541，但TCD较DSA诊断眼动脉代偿差异有统计学意义（P=0．039），DSA较TCD诊断后交通动脉及软脑膜动脉代偿差异亦有统计学意义（P=0．035，P=0．000）。内分水岭脑梗死与皮层分水岭脑梗死患者相比．颅内血管狭窄或闭塞的检出率及侧支循环代偿检出率差异均有统计学意义（x^2=-9．762，P=-0．002；x^2=-24．708，P=0．000）。结论TCD及DSA联合应用更有助于分水岭脑梗死颅内血管病变及侧支循环代偿情况的正确评估。Objective To study the value of transcranial Doppler （TCD） combined with digital subtraction angiography （DSA） in the evaluation of intracranial vessels in patients with cerebral watershed infarction. Methods The clinical and imaging data of 97 patients with cerebral watershed infarction, admitted to our hospital from June 2008 to June 2011, were retrospectively analyzed. All patients underwent TCD and DSA examination. Comparative analysis of TCD and DSA for intracranial stenosis diagnosis and compensatory collateral circulation in these patients was performed, and the advantages and disadvantages of TCD and DSA in these cases were compared. Results Eight hundred and seventy-three intracranial vessels of the 97 patients were analyzed. TCD and DSA showed no significant differences in evaluation of vascular stenosis or occlusion （P=0.503）. As to the collateral circulation, no significant differences between TCD and DSA were shown in the evaluation of anterior communicating artery compensatory （P=-0.754）, while TCD was more sensitive than DSA in the evaluation of ophthalmic artery compensatory （P=0.039）, and DSA was more sensitive in evaluating the posterior communicating artery and pial artery compensatory （P=0.035 and P=0.000）. The internal watershed infarction and cortical watershed infarction had significant differences in intracranial vascular stenosis or occlusion and collateral circulation 0（2=9.762, P=0.002; ）（2=24.708, P=-0.000）. Conclusion Combining TCD and DSA can contribute to judge the intracranial vascular lesions and collateral circulation correctly.

关 键 词：脑梗死 分水岭 经颅多普勒 数字减影血管造影 

分 类 号：R743.33[医药卫生—神经病学与精神病学]