颈内动脉严重狭窄或闭塞的超声诊断及临床价值

Ultrasonic Diagnosis of Carotid Stricture or Obliteration and Its Clinical Value

目的 :利用超声血管成像技术观察颈动脉严重狭窄或闭塞的血流动力学变化特点并探讨其临床价值。方法 :对 1 7例经二维及彩色多普勒超声检测的颈动脉狭窄或闭塞病例进行回顾分析。结果 :颈内动脉严重狭窄或闭塞全部发生在起始部。闭塞者 ,患侧颈总动脉血流速度减慢 ,同侧颈外动脉血流速度增快 ;严重狭窄者局部血流速度明显增快 ,其远端及近端血流速度减慢。其中 5例严重狭窄者行手术或介入治疗 ,术后血流动力学明显改善。结论 :超声血管成像技术直观、无痛苦创伤、重复性强 ,其二维图像可清晰的显示颈内动脉闭塞或狭窄程度 ,彩色多普勒可准确判定病变动脉血流动力学变化情况。二者结合 ,可对颈内动脉病变作出准确诊断、对其所引起供血不足作出预报 ,并对临床疗效进行观察评价。

Objective: To study the hemodynamic changes in carotid stricture or obliteration by ultrasound technique and its clinical value. Method: Review and analyze the 17 cases detected through two dimensional or ultrasonic Doppler techniques. Results: All carotid stricture or obliteration occurred at the initial part. In the case of obliteration, the velocity of blood flow in the common carotid artery of the affected side slowed down, while that in the external carotid artery speeded up. In the case of stricture, the velocity of blood flow in local area obviously speeded up, while that in the remote or nearby areas slowed down. Five stricture patients were operated on or given intervening therapy with improved hemodynamics. Conclusions: Two-dimensional pictures can clearly show internal carotid artery obliteration or stricture, and ultrasonic Doppler can accurately identify hemodynamic changes of pathologic arteries. The two in conjunction can lead to accurate diagnosis of internal carotid artery lesions, predict blood deficiency, and help with assessment of the clinical curative effect.