腔隙性脑梗死的TCD改变与CT诊断对比分析

Analysis of lacunar cerebral infarction by transcranial Doppler ultrasound and CT

目的:应用经颅多普勒超声(TCD)探讨以小动脉病变为主要发病机制的腔隙性脑梗死患者的血流动力学改变,与CT比较并进行相关分析。方法:利用TCD技术检测120例经CT或MRI确诊的腔隙性脑梗死患者,经颞窗探测双侧大脑中动脉、前动脉及后动脉;经枕窗探测双侧椎动脉、基底动脉;记录血流速度,观察频谱形态及监听音频变化、脉动指数及阻力指数等。结果:120例确诊为腔隙性脑梗死患者,TCD检测结果血流动力学异常109例(90.8%),脑动脉硬化112例(93.3%),血流速度正常11例(9.2%),差异有统计学意义(P<0.01)。CT/MRI显示96例(80%)梗死部位发生在基底节区和基底节合并放射冠、侧脑室旁等多发梗死灶。结论:患者同时行TCD和CT检测,对腔隙性脑梗死的临床诊断、病因和危险因素及治疗方案提供参考依据。

Objective：To explore the cerebral hemodynamics in patients with lacunar infarction which comes primarily from arteriolar occlusion, and analyze the features of transcranial Dopple r （TCD） and CT. Methods：There were 120 patients defined lacunar cerebral infarction by CT or MRI, and intracranial hemodynamics were measured with TCD, through recording blood velocity, observing the frequency spectrum form and listening the audio changes, pulsation index and resistance index in bilateral middle cerebral artery, anterior cerebral artery, posterior cerebral artery and vertebral artery basilar artery.Results：Among the 120 cases, there were 109 cases（ 90.8%）with hemodynamic abnormalities, 112 cases （93.3%） with cerebral arteriosclerosis, and 11 cases （9.2%） with normal blood flow velocity. According to CT scans, the most patients （96/120, 80%） showed lacunar infarction in basal ganglia. Conclusion：Applying the TCD and CT examination at one time can offer evidences for clinical diagnosis and detecting etiology and risk factors for patients with lacunar infarction.