TCD、MRA对儿童脑血管烟雾病诊断的对比研究

Examination and Analysis of Cerebral Blood Flow of Children's Moyamoya Disease b y Transcranial Cerebral Doppler

目的探讨经颅多普勒超声(TCD)在儿童烟雾病的特征表现并与核磁共振(MRA)对照比较其诊断价值.方法对6例由MRA确诊为烟雾病患儿的TCD检查资料比较分析.结果6例患者TCD获得的检测结果具有一定的特征性,TCD所测出的病变血管与MRA证实的病变部位基本符合.TCD与MRA对照分析结果:①MRA显示血管狭窄,TCD均见相应动脉血流速度增快;②MRA显示血管严重狭窄,TCD显示该血管血流速度减慢、血流频谱降低或无血流信号;③椎动脉系统因其与颈内动脉系统由后交通动脉相连,当颈内动脉系统出现狭窄闭塞,椎动脉系统血流代偿性增快,也为TCD所证实.结论TCD作为一种无创的检查手段,可以对烟雾病患者的脑血流进行追踪观察.对于烟雾病的早期诊断,具有重要的临床意义,并且具有明显优势.

Objective To observe the characteristic imaging of TCD and to compare with the MRA in order to study the TCD value in diagnosing the children＇s moyamoya disease. Methods We reviewed six moyamoya cases diagnosed by MRA and anulysised their examination results of TCD. The six cases include four females and two nudes, which from four months old to twelve years old. Result The six cases of moyamoya have a certain characters. Each case was compared with its TCD and MRA exam. ①The stricture vessels diagnosed by MRA could be detected by TCD, which shows the velocity of the blood flow higher. ②When the vessel was stricture seriously or even block, the velocity of the blood flow would lower than before, and sometimes we could not find the signal of the blood flow by TCD. ③If one vessels were stricture or block, the other vessel connected with it would be identified the blood flow higher as a result by TCD exam. Conclusion TCD may serve as a useful screening test to afford early information for diagnosing such a disease.