外伤性颈内动脉海绵窦瘘(TCCF)介入治疗前后经颅多普勒超声检测的临床意义

Clinical investigation of transcranial Doppler ultrasound examination before and after endovascular treatment of traumatic carotid cavernous fistula

目的 检测外伤性颈内动脉海绵窦瘘 (Traum atic carotid cavernous fistula,TCCF)介入治疗前后脑动脉血流动力学变化。方法 对 16例 TCCF患者采用 TCD检测颅底主要动脉的血流速度、脉动指数、频谱形态、声频变化。结果 治疗前患侧动脉出现快流速 ,低脉动指数、紊乱频谱血流信号伴明显杂音 ,尤以眼上静脉的异常为主。栓塞后异常血流信号消失。结论 TCD是协助诊断 CCF的无创伤方法。是监测介入治疗后 CCF是否完全栓塞的重要手段 ,压颈试验对了解侧枝循环非常重要。

Objective 16 cases of traumatic carotid cavernous fistula(TCCF) were examined by transcranial Doppler ultrasound(TCD) before and after endovascular treatment,the blood flow change of cerebral arteries were reported.Methods Using TCD to examine the speed of blood flow, pulse index(PI), pulse-frequency formation,sound-frequency change of the main arteries in cranial base.Results Before treatment,the blood of ipsilateral arteries were fast and PI were low, Frequency signs were diffuse,accompanied with murmur,the abnormalities were demonstrated mainly in upper ocular vein;abnormal blood flow signs disappeared after treatment.Conclusions TCD was an noninvasive method to help to diagnose TCCF,it can also explore if TCCF was occluded after endovascular treatment,Matas test was very important to investigate if there were collateral circulation.