颅外段椎动脉彩超检测在椎基底动脉供血不足中的临床应用

Clinical Application of Extracranial Vertebral Artery Color Dopplar Ultrasound Detection in Vertebrobasilar Ischemia

目的探讨椎基底动脉供血不足(VBI)患者颅外段椎动脉彩色多普勒超声声像图表现特征及其临床应用价值。方法对100例VBI患者(VBI组)行颅外段椎动脉彩色多普勒超声检查并与100例健康体检者(对照组)作对照分析。结果 100例VBI患者中:颅外段椎动脉管腔狭窄者37例,彩色多普勒超声表现为狭窄处血流束变细,彩色血流紊乱,收缩期峰值流速降低,阻力指数显著增大;椎动脉完全闭塞者1例,闭塞段管腔内完全无血流信号;椎动脉走行迂曲者50例,彩色多普勒超声表现为彩色血流束呈弯曲状,弯曲局部为双色或多彩血流;椎动脉走行变异者1例。VBI组共检出异常血管89例,检出率89%,对照组检出异常血管17例,检出率17%,两者比较,差异有统计学意义(P<0.01)。结论彩色多普勒超声可以显示颅外段椎动脉管壁的结构,判断椎动脉狭窄的程度和范围,检出椎动脉有无缺如、发育异常或走行变异。其操作简单、方便、准确、无创伤、可重复,对VBI的诊断和治疗具有重要临床意义。

Objective To explore the ultrasonographic performance characteristics and its clinical application value of extracranial vertebral artery in vertebrobasilar ischemia（VBI） patients.Methods To examine the color doppler ultrasound of extracranial vertebral artery of 100 cases of VBI patients（VBI group） line and the healthy check-up 100 patients（control group） as a control analysis.Results There are 37 cases with extracranial vertebral artery luminal stenosis in 100 cases of VBI patients,which color doppler sonography show narrow beam tapers in blood flow,color blood disorder,the peak systolic velocity decreases,resistance index increase significantly,there is 1 case which vertebral artery totally occluded without blood flow signals in block segments within the lumen,there are 50 cases with vertebral artery line feed tortuous,which color doppler sonography show curved shape of color doppler beam with double-color or colorful blood flow in bending local,there is 1 case which vertebral artery walk course variation.The VBI group were detected 89 cases of abnormal vascular,detection rate of 89%,the control group were detected 17 cases of abnormal vascular,detection rate of 17%,on both of them were compared,differences are significant（P0.01）.Conclusion Color doppler ultrasound can display the structure of extracranial vertebral artery vascular wall,judge the degree and scope of vertebral artery stricture,detect if the vertebral artery has been absence,developmental anomalies or walked course variation.The operation is simple,convenient and accurate,no wound and repeatable,for the diagnosis and treatment of VBI has important clinical significance.