经颅多普勒超声与磁共振血管造影的比较研究

The Compared Study of Transcranial Doppler Sonography (TCD) and Magnetic Resonance Angiography (MRA) to the Detection of Internal Cranial Large Arteries

目的 本研究利用经颅多普勒超声 (TCD)仪及磁共振血管造影 (MRA)技术 ,无创伤性地探查颅内大动脉的管腔情况及血流动力学情况 ,了解TCD与MRA探查脑血管狭窄性病变的可能性及相关性 ,探讨TCD在临床上的应用价值 ,以便能利用TCD仪观察脑血管疾病演变过程中 ,脑血管本身的病变过程。方法 对门诊就诊及住院的 91例患者 ,同时行TCD、MRA及磁共振成像 (MRI)检查 ,分析TCD、MRA的结果及两者的相符性 ,同时分析TCD的临床应用价值。结果 91例患者中仅 72例病人TCD显影良好。TCD显影良好的患者中 ,MRA显示有脑血管病变的患者 ,TCD也有相应变化的相符率。TCD显示异常的血管 ,MRA有相应变化的相符率。TCD异常的表现 ,主要为血流速度增快 ,其中又可分两侧对称型及不对称型。在不对称型患者中 ,TCD与MRA结果的相符率最高 ,在MCA及ACA中分别为 90 0 %、89 3%。结论 对高龄患者 ,TCD的检查有一定的局限性 ,主要是颞窗显影不佳 ;TCD对脑血管狭窄性病变检出的敏感性较低 ,特别是对后循环血管中的PCA及VA ;但对两侧不对称型的高血流血管 ,TCD对病变血管检出的特异度较高 。

Objective This study checks up the conditions of inner lumen in internal cranial large arteries and their hemodynamics with TCD and MRA harmlessly,understand the possibility and interrelationship that TCD and MRA detect the cerebrovascular stenotic disorders,evaluate the clinical employing values of TCD,so that observing the pathological process of cerebraovascular inner lumen itself during the evolution of the cerebrovascular diseases with TCD. Methods Checking up 91 cases from clinic and inpatient department with TCD,MRA and MRI simultaneously,analyzing the detecting results of TCD and MRA and the two′s correlation.In the meantime,analyzing thier clinical employing values. Results Only 72 of above 91 cases achieve good imaging of TCD.The patients whose MRA discover cerebrovascular disorders in above 72 cases.However,the abnormal cerebral vasculature that TCD discovers,the rate of relevant changes that MRA shows.The principally abnormal manifest that TCD discovers is the type of increasing blood flow velocity.This abnormal type is further devided into that of bilatery symmetry and that of bilateral non-symmetry.In patients of that of bilateral non-symmetry,the relevant rate of detecting results with TCD and MRA is highest,respectively 90 0% in MCA and 89 3% in ACA. Conclusion For patients of venerable age,there are some limits in detecting cerebral vasculature with TCD.It is principally the bad effects of imaging in temporal windows;The sensibility of discovering the stenotic disorders of cerebral artery with.TCD is lower,especially the PCA and VA of posterior circulation,but for cerebral artery with high blood flow velocity and being the type of bilateral non-symmetry,the specificity of TCD discovering the sick arteries is higher,and the corresponding rate of detecting results with MRA is higher,too. [