二维超声与TCD结合对椎-基底动脉延长扩张症的检测评价

Evaluation of 2D-ultrasonography and TCD in detection of vertebrobasilar dolichoectasia(VBD)

目的评价颈部血管超声与TCD结合对椎-基底动脉延长扩张症(VBD)的检测结果。方法对体检中有主述症状的386人和无主述症状的70人,同期分别做颈部血管超声和TCD检测,经筛选后55人为可疑组,并进一步做螺旋CT和磁共振检查。结果发现可疑组椎-基底动脉血管有不同程度的走形迂曲、变形、移位和血流动力学改变,其中血管走形迂曲左侧高于右侧,双侧低于单侧;血管内径扩张右侧高于左侧,双侧低于单侧;血流速度、阻力指数(RI)、弹性指数均与对照组相比有显著差异,与螺旋CT和磁共振检查结果对比阳性符合率达67.3%。结论超声技术对颅内、外血管病变的检测具有简便、经济、可重复性、快速安全的特点,易被操作者和患者接受,是比较理想的早期诊VBD的筛选方法之一。

Objective To evaluate cervical vascular ultrasound combined with transcranial doppler sonography（TCD）in detection of vertebrobasilar dolichoectasia（VBD）.Methods 386 cases of subjects with symptoms and 70 cases of subjects without symptoms in health examination were selected.All subjects were examined by cervical vascular ultrasound and TCD in the corresponding period of time.55 suspected VBD patients were further examined by CT and MRI.Results Basilar-vertebral arteries were tortuous,deformed,dislocated in different degree and had hemodynamic abnormality in the suspected VBD group.These blood vessels in left were more tortuous than those in right,bilateral less than unilateral.The internal diameter of blood vessels in right were more dilated than those in left,bilateral less than unilateral.There were no significant differences of the speed of blood flow,resistance index and elasticity between the suspected VBD group and control group.The positive coincident rate was 67.3 % compared with CT and MRI.Conclusion Ultrasound technique is a simple,economic,repetitive,fast and safe method which is easy to accept by operators and patients.It is one of the screening techniques for diagnosis of VBD at early stage.