单侧椎动脉狭窄患者椎动脉颈段、椎骨段多普勒超声研究

Doppler ultrasonography study on cervical segment artery and vertebral segment artery in patients with unilateral vertebral artery stenosis

目的应用多普勒超声观察单侧椎动脉狭窄患者椎动脉第1段颈段(VA1)、第2段椎骨段(VA2)的血流动力学改变。方法选择单侧椎动脉内径<2.8 mm的狭窄患者30例作为病例组,另选健康自愿者30例作为对照组,分别进行彩色多普勒(CDFI)及频谱多普勒(PW)血流显像检查,观察椎动脉走向,测其内径、峰值流速(Vmax)、阻力指数(RI)。结果对照组中VA1段内径、Vmax、RI均高于VA2段(P<0.05)。病例组:狭窄侧中VA1及VA2段的内径、Vmax低于对照组;RI高于对照组。健侧VA1、VA2段内径高于对照组(P<0.01或P<0.05);健侧VA1段Vmax高于对照组(P<0.05),健侧VA2段Vmax与对照组无明显差异(P>0.05);VA1、VA2段RI均高于对照组,但低于同组狭窄侧。狭窄侧和健侧VA1段的内径、Vmax、RI均高于VA2段。结论多普勒超声检测可以较直观地反映VA1及VA2的狭窄情况,较准确地测量其血流动力学参数,对诊断单侧椎动脉狭窄有实用价值。

Objective To use Doppler ultrasonography for the study of blood flow dynamic changes in cervical segment artery （ VA1 ）, vertebral segment artery （VA2 ） in patients with unilateral vertebral artery stenosis. Methods Color Doppler flow image （CDFI） combined with pulsed wave Doppler （PW） was used to define the course of vertebral artery and determine the parameters of blood flow for comparative study between two groups ： patient group （ 30 patients withstenotic vertebral artery＇s inner diameter 〈 2.8 mm） and control group （30 healthy subjects）. Results （ 1 ） The inner diameter： It was greater in VA1 than in VA2 in the normal control, but in the patient group, it was smaller than normal in the stenotic VA1 and VA2 and greater than normal in the non - stenotic ones （ P 〈 0. 05 ）. （2） The Vmax and RI ： In normal control group, they were bigger in VAt than in VA2 （ P 〈 0. 05）. In patient group, the Vmax, was smaller and the RI was bigger in the stenotic segments than normal （P 〈0.05）, but the Vmax of nonstenotic VA1 was bigger than normal （ P 〈 0. 05）. The RI of stenotic segments was bigger than normal, but smaller than that of the non - stenotic ones （ P 〈 0. 05）. Conclusion CDFI combined with PW can be used to assess the stenotic status of VA1 and VA2, measure blood flow dynamic parameters, and hence, is valuable to the diagnosis of unilateral vertebral artery stenosis.