经颅多普勒诊断脑血管痉挛的对比研究

Comparative study on transcranial Doppler ultrasonography and digital subtraction angiography in diagnosis of cerebral vasospasm

目的探讨经颅多普勒超声(TCD)诊断脑血管痉挛的可靠性。方法对50例蛛网膜下腔出血患者同时行TCD和数字减影血管造影(DSA)检查。结果DSA发现大脑中动脉(MCA)26条痉挛,其中TCD检出21条,DSA未证实有痉挛的MCA中,TCD检出4条痉挛,TCD诊断MCA痉挛的敏感性为80.8%,特异性为94.6%,MCA痉挛程度越重,TCD敏感性越高。DSA发现基底动脉(BA)18条痉挛,其中经TCD检出13条,DSA未证实有痉挛的BA中,TCD检出4条痉挛,TCD诊断BA痉挛的敏感性为72.2%,特异性为87.5%。DSA发现椎动脉(VA)28条痉挛,其中经TCD检出20条,DSA未证实有痉挛的VA中,TCD检出6条痉挛,TCD诊断VA痉挛的敏感性为71.4%,特异性为91.7%。结论TCD诊断MCA、VA、BA痉挛有较高的可靠性。

Objective To evaluate the reliability of transeranial Doppler ultrasonography （TCD） in the detection of cerebral vasospasm. Methods Digital subtraction angiography （DSA） and TCD examination were undertaken on 50 patients with subarachnoid hemorrhage. Results Twenty - six spasm of the middle cerebral artery （MCA）, 18 basilar artery （BA） and 28 vertebral artery （VA） were diagnosed by DSA,among which, corresponding 21, 13 and 20 spasm were detected by TCD respectively. The sensitive of TCD were 80.8 % in MCA, 72.2 % in BA and 71.4 % in VA. The specificity of TCD were 94.6 % in MCA, 87.5 % in BA and 91.7% inVA. Conclusions TCD is a reliable method in diagnosis of cerebral vasospasm.