TCD对颅内动脉狭窄诊断在飞行员体检中应用研究.docVIP

TCD对颅内动脉狭窄诊断在飞行员体检中应用研究 　　【摘要】 目的：探讨经颅多普勒检查（TCD）对颅内动脉狭窄的筛查与诊断中的作用，是否可作为飞行员体检时对脑血管狭窄的筛查手段。方法：经颅多普勒超声仪对97例患者探测双侧大脑中动脉（MCA）、大脑前动脉（ACA）、及大脑后动脉（PCA），观察上述动脉的收缩期血流速（Vs）、平均血流速（Vm）、脉动指数（PI）及各动脉的血流方向和多普勒频谱形态；同时进行核磁共振血管成像（MRA）检查。结果：结果表明，经颅多普勒检测和核磁共振检查结果有极其显著的符合性（P0.001），两种检查方法结果的ACA检测符合性为82.47%，MCA检测符合性为83.51%，PCA检测符合性为80.92%，总符合性为82.31%，TCD检测特异性为86%，敏感性为77%。结论：TCD与头部MRA对颅内动脉的狭窄评估结果的相符性良好。TCD检查简便易行成本低，可作为诊断颅内动脉狭窄的筛选手段。在飞行员体检中，若TCD检查正常，可不需要再行MRA检查；TCD提示血管狭窄时，可再进行MRA检查。 　　【关键词】 经颅多普勒； 磁共振血管成像； 缺血性脑血管病； 脑动脉狭窄 　　Application Research of TCD in the Diagnosis of Intracranial Artery Stenosis in the Pilot Medical Examination/WAN Rui，PAN Xiao-bo，WANG Fang.//Medical Innovation of China，2015，12（26）：121-123 　　【Abstract】 Objective：To investigate the effect of transcranial Doppler（TCD） for screening and diagnosis of intracranial artery stenosis，whether it can be used as a screening method for cerebral vascular stenosis in the physical examination of pilots.Method：The bilateral middle cerebral artery（MCA），anterior cerebral artery （ACA） and posterior cerebral artery（PCA） of the 97 patients were examined by transcranial Doppler ultrasonography.Systolic blood flow velocity（Vs），mean blood flow velocity（Vm） and pulse index（PI） of above arteries and blood flow direction and Doppler spectrum of each artery were observed.At the same time，simultaneous nuclear magnetic resonance angiography（MRA） was performed.Result：The results showed that，transcranial Doppler sonography and MRI results had a very significant compliance（P0.001）.The ACA consistency of the two methods was 82.47%，the MCA consistency was 83.51%，the PCA consistency was 80.92%，the total consistency was 82.31%.The specificity of TCD was 86% and the sensitivity was 77%.Conclusion：The evaluated result of TCD and MRA head for intracranial artery stenosis is good.TCD examination is simple and feasible， and can be used as a screening method for the diagnosis of intracranial artery stenosis.In the pilot physical examination，if the TCD examinat