TCD诊断缺血性脑卒中患者颅内动脉狭窄或闭塞准确性的临床研究

Clinical study of TCD in the diagnosis of intracranial artery stenosis or occlusion in patients with ischemic stroke

目的:探讨TCD诊断缺血性脑卒中患者颅内动脉狭窄或是闭塞的准确性及临床应用价值。方法:选取120例经DSA确诊为颅内动脉狭窄或闭塞的患者为观察对象。对观察者进行床头TCD检查,观察颅内血管的情况,并与DSA结果进行对比。结果:TCD对不同类型颅内血管狭窄或闭塞诊断的准确性存在差异。其中,颈内动脉系统血管狭窄的诊断准确性最高,最高达92.9%,椎-基底动脉系统血管狭窄的准确率为70.6%,且TCD能够显示某些DSA不能提供的血流信号,如盗血和栓子雨的形成。结论:与DSA比较,TCD在评估缺血性脑卒中患者颅内动脉狭窄或是闭塞的准确性较高,尤其是对于颈内动脉系统,同时TCD能提供DSA所不具备的实时血流动力学信息辅助临床医师诊断和治疗。

Objective：To investigate the accuracy and clinical application value of TCD in diagnosis of intracranial artery stenosis or occlusion in patients with ischemic stroke.Methods：Selected 120 patients with intracranial artery stenosis or occlusion diagnosed by DSA in inpatient department of our hospital as observation objects,and conducted bedside TCD check for them,then observed their intracranial blood vessels and compared with the results of DSA.Results：There exist different diagnostic accuracy in different types of intracranial vascular stenosis or occlusion through TCD.Among them,the accuracy of the diagnosis in stenosis of internal carotid artery system was the highest,up to 92.9%,and the accuracy rate of vertebrobasilar artery stenosis was 70.6%,and TCD is able to display some of the blood flow signals that cannot be provided by DSA,such as the formation of blood and embolic rain.Conclusion：compared with DSA,TCD is high accuracy in the evaluation of occlusion of intracranial artery stenosis in patients with ischemic cerebral stroke,especially for the internal carotid artery system,at the same time,while TCD can provide real-time hemodynamic information for clinicians to diagnose and treat that DSA does not have.