经颅彩色多普勒超声对脑动脉狭窄和脑动脉痉挛评价的对比研究

The Comparison of the Evaluation about Transcranial Color Doppler Ultrasonography inBrain Artery Stenosis and Brain Artery Spasm

目的 分析颅内大脑中动脉中、重度狭窄和颅内大脑中动脉收缩性痉挛血流速度及频谱、音频的变化,提高经颅彩色多普勒超声（TCCS） 对颅内大脑中动脉狭窄和颅内大脑中动脉收缩性痉挛鉴别诊断的准确性.方法 选取大脑中动脉狭窄患者 68例（狭窄组 ）和大脑中动脉收缩性痉挛患者 89例（痉挛组）.采用经颅彩色多普勒超声对有病变的大脑中动脉在同一支血管上实行两个深度检测,观察并记录血流束色彩、走行及频谱、音频的改变、血流速度及脉动指数（PI）、阻力指数（RI）的变化.结果 狭窄组动脉血流频谱及音频改变比例（100%）明显高于痉挛组（15.75%）.痉挛组在同一支血管上所采集的两个深度的血流速度、PI,RI无明显差异（P〉0.05）.狭窄组在同一支血管上所采集的两个深度的血流速度、PI、RI差异有显著性（P〈0.01）.痉挛组与狭窄组两个深度所采集的血流速度、PI、RI差异有显著性（P〈0.01）.结论 TCCS在检测到大脑中动脉血流速度异常增快,考虑大脑中动脉有狭窄或痉挛时,必须在有病变的同支血管上同时检测病变处、病变处远段二个深度的血流情况,并注意分析血流束、血流频谱与音频及血流速度的变化,方能提高TCCS对颅内大脑中动脉狭窄或痉挛诊断的准确性.

Objective To detect the moderate,severe stenosis and angiospasm of middle cerebral artery,and analyse the variation of blood flnw velocity（BFV） ,frequency spectrum and voice frequency. To improve the veracity of TCCS in detecting stenosis and angiost）asm of middle cerebral artery. Methods Sixty-eight cases with arteriostenosis and eighty-nine cases with anginspasm of middle cereln＇al artery was choosen. TCCS was use to detect two areas of the same vessel. The variation of the bloodstream eolour, distribution, frequency spectrum,voice frequency,BFV,pulsatility index and resistance index were ohserved and recorded. Results The frequency spectrum and voice frequency in the arleriostenosis group were significantly higher than that in angiospasm group. There were no significant dift;erence in BFV, P1, RI between the two areas in the same vessel in angiospasm grot, p. And there were significant difference in BFV,PI, RI between the two areas in the same vessel arteriostenosis group. There were significant difference in BFV, PI, RI between the two areas in the two groups. Couelusiou If atmormal ire＇teased BFV in middle cerebral artery will be deleeted,stenosis or angiospasm stenosis or angiospasm are considered. The B FV, PI, RI in two areas{ the area with vascnlarity Lesion and distal segment of diseased hlood vessels ） detected,and at the same time,the variation of the blnodstream will been analysed,frequency speetrmn,voice frequency and BFV, then were given more correct diagnosis. In order to improve Ihe diagnosis accuracy of TCCS in differentiating stenosis and anginspasm of middle cerebral artery.