彩色多普勒超声在双侧颈总动脉闭塞颅内外动脉侧支循环途径诊断中的应用研究

Application research on the diagnosis of diagnosis and intracranial and extracranial artery collateral circulation way in patients with bilateral common carotid artery occlusion using color Doppler ultrasound

目的探讨双侧颈总动脉(CCA)闭塞患者颅内外动脉侧支循环方式及血流动力学的变化。方法选择9例双侧CCA闭塞患者和27例健康成人作为研究对象,应用彩色多普勒超声检测颅内外动脉,观察CCA闭塞患者颈外动脉(ECA)反向血流入颈内动脉(ICA)、大脑后动脉(PCA)P1段峰值血流速度(Vs)是否大于健康成人的Vs值,从而判断ECA、Willis环后交通动脉(PCo A)侧支循环代偿途径。结果 9例患者均双侧ECA反向血流后进入ICA;2例双侧PCA的P1段Vs大于健康成人,7例单侧PCA的P1段Vs大于健康成人。结论双侧CCA闭塞患者存在ECA、PCo A两种侧支循环途径,彩色多普勒超声能准确、实时评价其血流动力学变化。

Objective To discuss the intracranial and extracranial artery collateral circulation way and hemodynamic changes in patients with bilateral common carotid artery （CCA） occlusion. Methods 9 patients with bilateral CCA oc- clusion and 27 healthy adults were enrolled in the study, their intracranial and extracranial artery were tested with color Doppler ultrasound.External carotid artery （ECA） reverse flow into the internal carotid artery ICA,and whether the peak velocity of P1 segment （Vs） in posterior cerebral artery （PCA） was greater than that of the healthy adults or not in pa- tients with CCA occlusion was observed to estimate the collateral circulation way of ECA and Willis ring of posterior communicating artery （PCoA）. Results 9 patients were bilateral ECA reverse flow into the ICA.2 case of bilateral PCA PI segment of Vs were greater than that of healthy adults,7 cases of unilateral PCA P1 segment of Vs were greater than that of healthy adults. Conclusion There are two kinds of collateral circulation way （ECA and PCoA） in these patients, color Doppler ultrasound can accurately,real-time evaluate the hemodynamic changes.