3D-DSA、TCD及颈动脉超声对颈动脉系统TIA的诊断价值

The diagnostic value of 3D-DSA,TCD and carotid ultrasonography in transient ischemic attack in carotid artery system

探讨三维数字减影血管造影(3D-DSA)、经颅多普勒(TCD)和颈动脉超声对颈动脉系统短暂性脑缺血发作(TIA)的诊断价值。方法对63例颈动脉系统患者进行3D-DSA、TCD和颈动脉超声检测,观察其异常情况。结果颈动脉3D-DSA异常18例(28.6%),脑3D-DSA异常48例(76.2%),二者均异常12例,大多为颈动脉轻-重度狭窄;TCD异常45例(71.4%,此45例脑3D-DSA也异常);颈动脉超声异常24例(38.1%,其中颈动脉3D-DSA异常18例)。结论3D-DSA、TCD和颈动脉超声3种方法联合应用,可对颈动脉系统的TIA病因及诊断作出客观评价。DSA是评价头颈部血管狭窄和选择治疗方案的金标准,它对缺血性脑血管病的进一步治疗起着重要的作用。

Objective To evaluate the value of three dimensional digital subtraction angiography （3D-DSA） ,transcranial doppler sonography （TCD） and carotid ultrasonography in diagnosis of transient ischemic attack （TIA） in carotid artery system. Methods 3D-DSA,TCD and carotid ultrasonography examinations were performed in 63 patients with carotid disease, and then the abnormal ity of carotid artery system was analyzed. Results 3D-DSA abnormality of carotid artery was 18 cases （28.6%） ,cerebral artery abnormality was 48 cases （76.2%） ,and 12 cases were abnormal in both,while most of them showed mild-severe carotid artery stenosis;the abnormality of TCD was 45 cases （71.4%）;and the abnormality of carotid ultrasonography was 24 cases （38. 1%）,in which 18 cases were carotid artery 3D-DSA abnormal. Conclusion United application of 3D-DSA,TCD and carotid ultrasonography can perform objective evaluation on the etiology and diagnosis of carotid disease. As the gold standard for the diagnosis and treatment of cerebral or carotid artery stenosis as well as selection of therapeutic regimen,DSA plays an impotant role in the further interventions of ischemic cerebrovascular disease.