高频超声联合经颅彩色多普勒超声评价急性脑梗死患者颈动脉及颅内动脉结构与功能改变

Evaluation of the alterations of structure and function of carotid artery and cerebral artery in acute cerebral infarction with high-frequency ultrasound combining with transcranial color coded duplex sonography

目的应用高频超声联合经颅彩色多普勒超声(TCCS)评价急性脑梗死患者颈动脉及颅内动脉结构与功能改变。方法选择急性大脑中动脉供血区脑梗死患者29例(脑梗死组)及正常人30名(对照组),以高频超声测量颈动脉收缩期血管内径(Ds)、血管内-中膜厚度(IMT),记录粥样硬化斑块部位、形态、回声类型及斑块数目并测量大小;以TCCS检测双侧大脑中动脉(MCA)收缩期血流峰值速度(Vs)、舒张末期血流速度(Vd)、搏动指数(PI)及阻力指数(RI)。结果脑梗死组颈总动脉Ds、最大IMT与平均IMT均大于对照组,脑梗死组颈动脉斑块个数、多发斑块血管数、混合性回声和低回声斑块个数均多于对照组(P<0.05)。脑梗死组患侧和健侧MCA的RI均高于对照组(P<0.05),脑梗死组患侧MCAPI高于对照组(P<0.05)。结论高频超声联合TCCS评价颈动脉及颅内动脉粥样硬化改变,为无创、早期诊断脑梗死提供了有用的参考指标,有一定临床实用价值。

Objective To explore the alterations of the structure and function of carotid artery and cerebral artery in patients with acute cerebral infarction with high-frequency ultrasound combining with transcranial color coded duplex sonography （TCCS）. Methods Both 29 patients with acute cerebral infarction attacked middle cerebral artery and 30 healthy subjects （as control group） were examined with high-frequency ultrasound and TCCS. The intima-media thickness （IMT）, the echo and number of plaques, the systolic diameter （Ds） of the carotid arteries and the systolic velocity （Vs）, the diastolic velocity （Vd）, the pulsatility index （PI） and the resistance index （RI） of the middle cerebral artery （MCA） were measured. Results The maximum IMT, mean IMT and Ds were larger in the acute cerebral infarction group than those in the controls. The number of carotid plaques, vessel with multi-plaques and the lower-echo and mixed-echo plaques were more in the acute cerebral infarction group （P0.05）. RI of MCA of both the damaged side and the normal side was higher than those in the control subjects （P0.05）. PI of MCA of the damaged side in the cerebral infarction subjects was higher than that in the control subjects （P0.05）. Conclusion High-frequency ultrasound combining with TCCS is a convenient method to evaluate carotid artery and cerebral artery atherosclerosis, which may provide some useful information for diagnosis of acute cerebral infarction.