超声评价单侧颈内动脉闭塞者颈部动脉血流动力学改变

The hemodynamic changes of carotid and vertebral artery in patients with unilateral internal carotid artery occlusion by color duplex imaging

目的应用超声评价单侧颈内动脉闭塞患者颈部其他动脉血流动力学改变。方法 50例单侧颈内动脉闭塞患者(闭塞组)及50例体检健康者(对照组),超声检查其颈总动脉、颈内动脉、颈外动脉及椎动脉的内径、收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)、平均血流速度(MV)、搏动指数(PI)及阻力指数(RI),并计算颈总动脉与同侧颈外动脉的PSV比值、PI比值及RI比值。结果①闭塞组患侧颈总动脉的PSV、EDV及MV较健侧及对照组降低,PI和RI增加(P﹤0.05);患侧及健侧颈外动脉的PSV及MV较对照组增加(P﹤0.05);患侧椎动脉的内径、EDV、MV较健侧及对照组增加(P﹤0.05);健侧颈内动脉的PSV及MV较对照组增加(P﹤0.05)。②与健侧及对照组相比,患侧颈总动脉与颈外动脉的PSV比值、EDV比值及MV比值减小(P﹤0.01),PI比值和RI比值增大(P﹤0.05)。结论超声不仅可直接诊断颈内动脉闭塞,也可评价单侧颈内动脉闭塞后颈部其他动脉的血流动力学改变。

Objective To analyze the hemodynamic change of the rest carotid arteries in patients with unilateral internal carotid artery （ICA） occlusion by color duplex imaging （CDI）and to evaluate the compensation of cerebral blood flow. Methods Fifty patients with unilateral ICA occlusion and fifty normal cases were examined by CDI. Results Compared with uninjured lateral and normal cases, the PSV, EDV, and MV of injured lateral CCA were decreased, while PI and RI were increased. The PSV and MV of bilateral ECA were increased compared with normal cases, the diameter, EDV and MV blood flow of injured lateral VA were higher than uninjured lateral and normal cases ; the PSV and MV of uninjured lateral ICA were higher than normal cases. Compared with uninjured side and normal cases,the PSV,EDV and MV ratio of CCA and ECA of injured side was decreased,PI CCA/PI ECA and RI CCA/RI ECA were increased. Conclusion Ultrasonography carl not only directly diagnosis the ICA occlusion hut evaluate the hemodynamic changes of the rest carotid arteries.