TCD对颅内动脉狭窄的诊断在飞行员体检中的应用研究

Application Research of TCD in the Diagnosis of Intracranial Artery Stenosis in the Pilot Medical Examination

目的:探讨经颅多普勒检查(TCD)对颅内动脉狭窄的筛查与诊断中的作用,是否可作为飞行员体检时对脑血管狭窄的筛查手段。方法:经颅多普勒超声仪对97例患者探测双侧大脑中动脉(MCA)、大脑前动脉(ACA)、及大脑后动脉(PCA),观察上述动脉的收缩期血流速(Vs)、平均血流速(Vm)、脉动指数(PI)及各动脉的血流方向和多普勒频谱形态;同时进行核磁共振血管成像(MRA)检查。结果:结果表明,经颅多普勒检测和核磁共振检查结果有极其显著的符合性(P<0.001),两种检查方法结果的ACA检测符合性为82.47%,MCA检测符合性为83.51%,PCA检测符合性为80.92%,总符合性为82.31%,TCD检测特异性为86%,敏感性为77%。结论:TCD与头部MRA对颅内动脉的狭窄评估结果的相符性良好。TCD检查简便易行成本低,可作为诊断颅内动脉狭窄的筛选手段。在飞行员体检中,若TCD检查正常,可不需要再行MRA检查;TCD提示血管狭窄时,可再进行MRA检查。

Objective： To investigate the effect of transcranial Doppler （ TCD ） for screening and diagnosis of intracranial artery stenosis, whether it can be used as a screening method for cerebral vascular stenosis in the physical examination of pilots.Method： The bilateral middle cerebral artery （ MCA ）, anterior cerebral artery （ ACA ） and posterior cerebral artery （ PCA ） of the 97 patients were examined by transeranial Doppler ultrasonography.Systolie blood flow velocity （ Vs ）, mean blood flow velocity （ Vm ） and pulse index （ PI ） of above arteries and blood flow direction and Doppler spectrum of each artery were observed.At the same time, simultaneous nuclear magnetic resonance angiography （ MRA ） was performed.Result： The results showed that, transeranial Doppler sonography and MRI results had a very significant eornpliance （ P〈0.001 ） .The ACA consistency of the two methods was 82.47%, the MCA consistency was 83.51%, the PCA consistency was 80.92%, the total consistency was 82.31%.The specificity of TCD was 86% and the sensitivity was 77%.Conclusion： The evaluated result of TCD and MRA head for intraeranial artery stenosis is good.TCD examination is simple and feasible, and can be used as a screening method for the diagnosis of intraeranial artery stenosis. In the pilot physical examination, if the TCD examination is normal, you can not need to do MRA inspection; MRA can be checked when TCD suggests that the narrow blood vessel.