彩色多普勒超声联合DSA在脑分水岭梗死颅外段动脉评价中的作用  

Application of CDFI combined with DSA in evaluation of extracranial arteries in the patients of cerebral watershed infarction

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

机构地区：[1]徐州医学院第二附属医院神经内科,江苏221006

出　　处：《脑与神经疾病杂志》2015年第4期301-305,共5页Journal of Brain and Nervous Diseases

基　　金：徐州市科技局课题(XM12M041);徐州市医学青年后备人才项目;徐州市医学领军人才项目

摘　　要：目的探讨彩色多普勒超声(CDFI)联合全脑数字减影血管造影(DSA)对脑分水岭梗死患者颅外段动脉评价中的作用。方法分析本院2008年1月至2011年12月的92例脑分水岭梗死患者的临床及影像学资料,比较颈部CDFI及DSA两种检查手段对颅外段动脉评价中的优缺点;比较皮质分水岭梗死和内分水岭梗死的颅外段血管病变情况。结果对92例552条血管进行检查,DSA共发现52条血管狭窄,8条血管闭塞;CDFI共发现有64条血管狭窄,12条血管闭塞。两者总体对血管狭窄及闭塞的诊断比较差异无统计学意义(P>0.05)。对于动脉粥样硬化斑块性质的判断,两者之间比较差异有统计学意义(P<0.05)。皮质分水岭梗死与内分水岭在动脉狭窄或闭塞及不稳定斑块方面差异有统计学意义(P<0.05)。结论 CDFI及DSA对分水岭脑梗死颅外段供血动脉病变的判断具有重要意义且各具优缺点:DSA是诊断血管狭窄或闭塞的金标准,但对动脉硬化斑块性质的判断存在局限性;彩超能准确判断动脉粥样硬化斑块性质,但对血管狭窄或闭塞的判断存在一定的假阳性率。联合应用有助于对患者颅外段动脉的评价。Objective To study the value of color Doppler imaging （ CDFI） and digital subtraction angiography（DSA） in the evaluation of extracranial arteries in patients with cerebral watershed infarction.Methods Analyze the clinical and imaging data of 92 cases of cerebral watershed infarction patients during the period from 2008 January to 2011 December.Analyzed the clinical value of color Doppler and DSA on the evaluation of extracranial arteries and compared the advantages and disadvantages of the two ways.Results We examined 552 neck arteries in the 92 patients , 52 artery moderate or severe stenosis and 8 artery occlusion were confirmed by DSA. By CDFI way, 64 artery stenosis and 12 artery occlusion were confirmed.The overall showed no significant difference in the diagnosis of vascular stenosis and occlusion （P〉0.05）.For the character of atherosclerotic plaques, The results showed that CDFI is superior to DSA （P〈0.05）.between internal watershed and cortical watershed infarction, there were significant differences in unstable atherosclerotic plaque and arterial stenosis or occlusion （ P 〈0.05）. Conclusion It is significant of CDFI and DSA to judge the extracranial arteries lesions in patients with cerebral watershed infarction.The two ways both have advantages and disadvantages.DSA is the gold standard in the diagnosis of arteries stenosis or occlusion but has limitations in judgment of the character of the atherosclerotic plaques; can ac-curately judge the signal of atherosclerosis plaques, but has certain false positive rate in judgment of the arteries ste-nosis or occlusion .To combine the two ways is help for judging the disease and choosing the correct treatment.

关 键 词：分水岭梗死 彩色多普勒超声 数字减影血管造影 

分 类 号：R743.32[医药卫生—神经病学与精神病学]