TCD转颈试验的诊断价值及检测方法的探讨

Evaluation of Diagnosis Value of Three Turning-neck Tests by Using TCD

目的探讨经颅多普勒(TCD)转颈试验对椎基底动脉供血不足(VBI)的诊断价值及最佳检测方法。方法三种方法随机选择了三组病人,按双椎动脉转颈组(Ⅰ组),双椎动脉(VA)+基底动脉(BA)转颈组(Ⅱ组)及BA转颈组(Ⅲ组),分别对颈椎病伴VBI患者进行TCD转颈试验。结果Ⅰ组转颈后阳性率由常规检查的74．07%(40/54)提高到90．74%(49/54),提高了16．67%(9/54)；Ⅱ组转颈后阳性率由常规检查的73．21%(41/56)提高到91．07%(51/56),提高了17．85%(10/56)；Ⅲ组转颈试验后阳性率为62．50%(35/56)。结论TCD转颈试验对颈椎病等引起的VBI患者能提高检出率,优选方法以VA转颈组结果较理想,其优点是时间短、费用低、检出率高。

Objective To evaluate the roles of three turning-neck tests by using transcranial doppler(TCD)for diag- nosing vertibro-basilar artery insufficiency(VBI).Methods Three turning-neck tests using TCD were evaluated in this study.The patients suffered from cervical spondylosis combined with vertibro-basilar artery insufficiency(VBI)were en- rolled randomly into group I(bi-vertebre artery turning-neck test),groupⅡ(bi-vertebre artery & basilar artery turning- neck test)and groupⅢ(basilar artery turning-neck test),respectively.Results The detected positive rates were 90.74%(49/54)and 91.07%(51/56)in group I and groupⅡrespectively,which showed increased rates of 16.67%(9/54) and 17.85%(10/56)as compared with those of the normal test(74.07 % and 73.21%,respectively).The positive rate in groupⅢwas 62.50 %(35/56),Conclusion The detected rate of VBI in cervical spondylosis patients is increased by using TCD turning-neck tests;and vertebre artery(VA)turning-neck test may be the most promising method with the character- istics of short test time,lower expense and high detected rate.