脑梗塞患者颈动脉超声检测

The Ultrasonographic Findings of Carotid Artery in Cerebral infarction

本文观察脑梗塞患者41例,均经CT定位诊断;分为非梗塞侧（第Ⅰ组,31例）,梗塞侧（第Ⅱ组,51例）,并与正常对照（第Ⅲ组,65例）。主要探讨颈内动脉、椎动脉颅外段硬化性病变及血流动力学情况与梗塞灶的关系。使用高分辨力彩色多普勒超声诊断仪检测颈部颈动脉。结果显示:脑梗塞两组颈动脉内径增宽;内膜-中层增厚;舒张期末流速、时间平均流速降低;阻力指数、搏动指数增高;斑块发现率、管腔狭窄率均明显增高。梗塞侧与非梗塞侧相比,内膜-中层厚度、软斑块发现率前者略高于后者,其余参数均无统计学差异。斑块及颈动脉狭窄与梗塞病灶无明显同侧关系。提示颈动脉硬化与脑梗塞有一定的关系,但尚不能通过颅外颈动脉超声扫查对脑梗塞作出确切定位性评估。软斑块易引起重度狭窄,斑块溃疡或出血,稳定性差,可能与梗塞有较为直接的因果关系,应引起临床及超声医生的高度重视。

This article presented the obvserration of changes on cerebral infarction diagnosed by CT. These arteries were divided into two groups: group I (no infarction side n = 31), group II (infarction side n = 51). Group III (n = 65 ) was taken for normal controll. The relations among cervical carotid atherosclerosis, hemodynamics and cerebral infarct lesions were analyzed by high resolution color Doppler ultrasound. The results indicated that the diameters of carotid arteries were significantly enlarged accompanied by intimal - medial thickening, decrease of end - diastolic velocity (EDV) and the time average velocity (Vmean), and incrase of the resistive index(RI) and pulsatility index (PI). The incidence of formations of plaque and stenosis were significantly high in group I and group II . The results showed the intimal - medial thickness and incidence of soft plaque formation were a little bit higher in the group II than those of group II. The rest parameters possessed no statistical significance. It suggested that there're some relationships between cervical carotid atheroscleroses and cerebral infarction but yet can not estimate the sites of infarction by ultrasound. It had not been found that the ipsilateral relation of the plaque or/and stenosis of carotid arteries to the cerebral infarction. The soft plaques were unstable easily to be ulcerated, undergone bleeding and severely stenosed and thus may lead to cerebral infarction. Much attention was necessary.