经颅多普勒及彩色经颅多普勒超声与DSA对烟雾病诊断的比较分析

Comparison of effects of transcranial Doppler sonography and transcranial color Doppler ultrasonography on diagnosis of Moyamoya disease with that of DSA

目的探讨经颅多普勒(TCD)及彩色经颅多普勒超声(TCCD)对烟雾病诊断的临床应用价值。方法采用TCD及TCCD探测137例烟雾病患者颅内血管血流动力学的改变,并与其DSA结果比较分析。结果 TCD探测24例,明确诊断22例,高度怀疑1例,阴性者1例,与DSA比较诊断符合率为96%。TCCD探测113例,明确诊断102例,高度怀疑8例,因无透声窗检测失败3例,与DSA比较诊断符合率为97%。结论 TCD及TCCD均能实时动态地观察颅底血管血流动力学的改变,而TCCD对颅内动脉狭窄处血流显示更敏感,更有助于准确判断血管闭塞与轻度狭窄,对烟雾病的诊断具有更高的应用价值;又因其无创,病人易接受,两者可作为烟雾病患者诊断、定期随访的首选方法。

Objectives To summarize the experiences in diagnosing Moyamoya disease by transcranial color Doppler ultrasonography （TCCD） and to evaluate the clinical value of TCCD to noninvasive diagnosis of Moyamoya disease.Methods Of 137 patients with Moyamoa disease diagnosed as by DSA,24 received transcranial Doppler （TCD） examination and 113 did TCCD.The outcomes of TCD and TCCD examination were compared to that DSA which was performed in all the patients.Results The diagnosis of Moyamoya disease was definitely made by TCD in 22,Moyamoya disease was highly suspected in 1 and Moyamoya disease was not detected in 1 of the 24 patients with Moyamoya disease receiving TCD.The positive detected rate of Moyamoya disease by TCD was 95.8%.The diagnosis of Moyamoya disease was definitely made by TCCD in 102,Moyamoya disease was highly suspected in 8 and TCCD examination failed of success in 3 because there were not bone windows through which the sound passed.Conclusions The vessels in the brain bases and changes in their hemodynamics can dynamically be observed in real time by TCD and TCCD.TCCD is more helpful to estimating the occlusion and light stenosis of the intracranial vessels and it is of higher value to diagnosing Moyamoya disease than TCD because it is more sensitive to the blood flow in the stenosed vessels.TCD and TCCD,which are noninvasive methods,should be firstly selected for diagnosing and following up in the patients with Moyamoya disease.