215例椎动脉型颈椎病患者颅外椎动脉结构及血流动力学的变化

Morphological and hemodynamic changes of extracranial vertebral artery in patients with cervical spondylotic arteriopathy

目的通过检测颅外椎动脉结构及血流改变,探讨彩色多普勒超声技术诊断椎动脉型颈椎病(CSA)的价值。方法回顾性分析215例CSA患者(病变组)颅外椎动脉形态结构及血流动力学改变,并与100名健康者(对照组)进行比较。结果 215例CSA患者有5种形态结构改变,依次为狭窄82例(38.1%)、发育不良64例(29.8%)、窃血32例(14.9%)、扭曲22例(10.2%)和闭塞15例(7.0%)。与对照组比较,病变组椎动脉病内径、收缩期峰值流速、舒张末流速及血流量明显降低,而阻力指数明显增高(P<0.01)。结论彩色多普勒超声检测颅外椎动脉形态结构及血流动力学变化可为临床诊断CSA提供可靠依据。

Objectives To investigate the value of color Doppler ultrasonography in the diagnosis of cervical spondylotic arteriopathy（CSA） by detecting morphological and hemodynamic changes of extracranial vertebral artery（EVA）. Methods The morphological and hemodynamic changes of the EVA of 215 patients with CSA were retrospectively analysed by color doppler sonography, and were compared with those of 100 healthy persons（Control Group）. Results Of 215 CSA patients, there are 82 cases with EVA stenosis（38.1%）, 64 cases with EVA hypoplasia（29.8%）, 32 cases with EVA steal（14.9%）, 22 cases with EVA tortuous（10.2%）, and 15 cases with EVA occlusion（7.0%）. Compared with Control Group, the diameter, PSV, EDV and volume of blood flow in the CSA patients were significantly reduced, but the RI was significantly increased（P〈0.01）. Conclusion Color Doppler ultrasonography provides reliable evidence for the diagnosis of CSA by detecting the morphological structure changes of the EVA.