双焦距经颅多普勒在大脑中动脉狭窄患者检测微栓子的研究

Bigated transcranial Doppler for detection of microembolic signals in patients with middle cerebral artery stenosis

目的 研究大脑中动脉（ＭＣＡ）狭窄患者采用ＴＣＤ检测微栓子（ＭＥＳ）的诊断价值。方法 对２１ 例年龄在３５～５７ 岁的单侧ＭＣＡ 狭窄患者，经ＣＴ／ＭＲＩ证实为脑梗死。均进行３０ 分钟的双焦距ＴＣＤ监测。结果 ４例（１９．０％ ）检测到ＭＥＳ。其中３ 例在狭窄远端检测到，１ 例近、远端均检测到。均为大面积脑梗死（４／１３，３０．８％ ），而腔隙性梗死未发现ＭＥＳ。结论 双焦距ＴＣＤ检测ＭＥＳ对于确定栓子来源有重要价值，同时说明ＭＥＳ与大面积梗死有关。

Objective To study the diagnostic value on the relevance of transcranial Doppler (TCD) monitoring for the microemblic signals (MES) in patients with middle cerebral artery (MCA) stenosis. Methods 21 patients with unilateral MCA stenosis (the range of their ages from 35 to 57 years) were demonstrated as cerebral infarction by CT and MRI. All patients were performed bigated TCD monitoring for 30 min in unilateral MCA. ResultsIn 4 patients (19.0%) MES detection could be performed sufficiently at unilateral MCA, among which 3 cases were detected in stenosis long end. Only one was detected in short and long end. CT/MRI results showed that the all MES were detected in patients with large size infarction (4/13, 30.8%), but in the patients with lacunae infarction lesion no MES were detected. Conclusion Bigated probe monitoring for detection of MES were suitable and allowed identification of the source embolic. There was correlation between MES and large vessel territory cerebral infarction.