经颅超声血流特性与大脑中动脉狭窄性疾病的相关性研究

The relevant research on the blood flow characteristics of transcranial ultrasound and the disease with MCA stenosis

目的:研究经颅超声血流特性与大脑中动脉(MCA)狭窄程度的相关性,探讨经颅多普勒超声(TCD)在MCA狭窄性疾病诊断中的应用价值。方法:选取医院接诊的82例脑血管病患者,分别进行数字减影血管造影(DSA)和TCD检查,分析DSA影像中MCA狭窄的长度比例和TCD影像中MCA狭窄的血流特性参数值,采用Spearman相关分析法对两种检查方法的诊断结果进行相关性分析。结果:经DSA检查,82例患者的164条血管段中无狭窄、轻度狭窄、中度狭窄及重度狭窄的数量分别为59条、48条、37条和20条,其收缩期峰值流速(PSV)值、平均流速(Vm)值与狭窄长度呈显著相关水平(r≥0.6),而搏动指数(PI)参数值与血管狭窄长度比例呈弱负相关(0>r≥-0.3)。TCD诊断PSV参数受试者工作特征(ROC)曲线下面积(AUC)MCA无狭窄、轻度狭窄、中度狭窄和重度狭窄分别为0.813、0.854、0.868和0.929,均>0.8。结论:应用TCD的PSV和Vm参数指标进行MCA狭窄程度的诊断准确率高,具有较高的临床诊断价值。

Objective: To research the correlation of the blood flow characteristics of transcranial ultrasound and the degree of middle cerebral artery(MCA) stenosis, and explore the application value of transcranial Doppler sonography(TCD) in diagnosing the disease of MCA stenosis. Methods: 82 patients with cerebrovascular disease admitted to hospitals were selected. All of them underwent digital subtraction angiography(DSA) and TCD examination, respectively. The length ratio of MCA stenosis in DSA images and the parameters of blood flow characteristics of MCA stenosis in TCD image were analyzed, and Spearman was adopted to analyze the correlation of the diagnostic results of the two examination methods. Results: The DSA results showed that the numbers of vessel without stenosis, mild stenosis, moderate stenosis and severe stenosis in 164 segments of 84 patients were 59, 48, 37 and 20, respectively. And the peak systolic velocity(PSV) value and mean velocity(Vm) were significantly correlative with the length of stenosis(r≥0.6), and parameter value of pulsatility index(PI) appeared gently negative correlation with the length of stenosis of blood vessels(0>r≥-0.3). The area under curve(AUC) of ROC curve of MCA without stenosis, mild stenosis, moderate stenosis and severe stenosis of PSV parameter in the diagnosis of TCD were 0.813, 0.854, 0.868 and 0.929, respectively, and all of them were higher than 0.8. Conclusion: The diagnosis of PSV and Vm of TCD for the degree of MCA stenosis has high accuracy and it has higher clinically diagnostic value.