经颅多普勒超声联合双频超声检测椎动脉支架植入术的血流动力学改变  

Transcranial doppler combined with color doppler flow imaging to detect the hemodynamic changes of vertebral arteryostium stenting

作　　者：冯晓敏[1] 秦超[2] 陈娅[2] 韦馨娴 覃冬华[1] Feng Xiaomin;Qin Chao;Chen Ya;Wei Xinxian;Qin Donghua(Department of Neurology,Guangxi Minzu Hospital,Nanning 530001,Guangxi,China;Department of Neurology,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi,China)

机构地区：[1]广西民族医院神经内科,广西南宁530001 [2]广西医科大学第一附属医院神经内科,广西南宁530021

出　　处：《右江民族医学院学报》2022年第3期432-435,448,共5页Journal of Youjiang Medical University for Nationalities

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z20180607)。

摘　　要：目的研究经颅多普勒超声技术(TCD)联合双频超声彩色多普勒技术(CDFI)在椎动脉起始段支架植入前后血流动力学变化及使用价值。方法椎动脉起始段重度狭窄患者30例,在手术前3 d及术后3 d行TCD和CDFI检查,与全脑血管造影术(DSA)比较CDFI的狭窄率、诊断符合率,观察血管成形术前后血管内径、狭窄率及血流动力学改变。结果CDFI在支架手术前、术后狭窄发生率分别为(79.94±7.74)%、(23.44±6.48)%,使用DSA测的狭窄率为(81.18±6.78)%、(22.12±6.34)%,两者相比较结果无明显差异(P>0.05);CDFI联合TCD检查发现支架术后管腔内径明显增加、椎动脉起始段收缩期峰值血流流速(PSV)、阻力指数较术前明显降低,椎动脉椎间段、颅内段PSV、阻力指数、血管搏动指数较术前明显升高,差异均有统计学意义(P<0.05)。结论TCD与CDFI联合应用是一种精确评估椎动脉起始段狭窄支架植入术前血流动力学变化,并评估术后效果的重要无创检查方法。Objective To explore the value of transcranial doppler(TCD)and color doppler flow imaging(CDFI)for detecting the hemodynamic changes before and after vertebral artery ostium stenting.Methods This study enrolled 30 patients with severe stenosis in the initial segment of vertebral artery.TCD combined with CDFI examinations and digtal subtraction angiography(DSA)were performed for them 3 days before and 3 days after operation.The stenosis rate and diagnostic coincidence rate of CDFI were compared.And the changes of vascular diameter,stenosis rate and hemodynamics were observed before and after angioplasty.Results The stenosis rates detected by CDFI before and after surgery were(79.94±7.74)%and(23.44±6.48)%,respectively.The stenosis rates detected by DSA were(81.18±6.78)%and(22.12±6.34)%,and there was no significant difference between them(P>0.05).CDFI combined with TCD examination showed that the lumen diameter significantly increased.The peak systolic flow velocity(PSV)and resistance index in the initial segment of vertebral artery significantly decreased after surgery.And the PSV,resistance index and pulse index of vertebral artery intervertebral segment and intracranial segment were significantly higher than those before surgery.The differences were statistically significant(P<0.05).Conclusion The combination of TCD and CDFI is an important noninvasive method which can accurately evaluate the hemodynamic changes before vertebral artery ostium stenting as well as evaluate the postoperative outcomes.

关 键 词：超声检查 多普勒 彩色 超声检查 多普勒 经颅 血流动力学 支架植入术 

分 类 号：R455.1[医药卫生—运动医学]