经颅多普勒超声诊断脑血管狭窄与脑血管造影的对比分析医学论文.docVIP

经颅多普勒超声诊断脑血管狭窄与脑血管造影的对 比分析 关键词I脑血管造影术 Comparison between transcranial Doppler and cerebral vascular angiography in diagnosis of intracranial artery stenosis [Abstract ] AIM: To explore the diagnostic value of transcranial Doppler (TCD) for intracranial artery stenosis in comparison with cerebral vascular angiography (CVA). METHODS: Eightytwo patients were divided into 2 groups: 14 nonocclusive cerebrovascular diseases (NCD group) and 68 occlusive cerebrovascular diseases (OCD group). All the patients underwent TCD (2 MHz and 4 MHz respectively) and CVA examination. RESULTS: In OCD group, 690 arteries were detected，among which，CVA and TCD showed 80 and 69 stenotic arteries, respectively. Of the 69 stenotic arteries by TCD, 60 were consistent with those by CVA. Analysis showed that the sensitivity and the specificity of TCD were respectively 75.0% and 98.5% in the diagnosis of intracranial stenosis arteries. In NCD group, 147 arteries were detected. Only 1 stenotic artery was diagnosed by both TCD and CVA. CONCLUSION: TCD can objectively reflect the cerebral hemodynamic changes in cerebral vessels and can be used to diagnose the stenotic diseases of carotid and intracranial arteries. [Keywords ] artery stenosis, ultrasonography, doppler, transcranial; cerebral vascular angiography 】目的：比较脑血管造影和经颅多普勒超声(TCD)对闭塞 性脑血管疾病的诊断价值.方法：82例患者分为两组，非闭塞性脑血 管病组14例，闭塞性脑血病组68例，分别用2 MHz和4 MHz多 普勒探头检查颅内和颈部血管血流速度，进行脑血管造影(CVA)检 查.结果：闭塞性脑血管病组，共检出血管690条，TCD检出狭窄血 管69条，621条正常，其中60条与CVA所见一致，CVA发现狭 窄血管80条，统计结果显示TCD诊断血管狭窄的敏感性75.0%, 特异性98.5%.非闭塞性脑血管病组共检出血管147条，TCD检出 狭窄血管1条与DSA结果一致.结论：TCD可客观地反映脑血流动 力学的改变，可作为脑血管狭窄预防性筛选方法之一. ［关键词】 ［关键词】 动脉狭窄；经颅多普勒;脑血管造影术 0引言 经频多普勒超声(transcranial D叩pier，TCD)作为无创性检 测颅内外血流动力学已广泛应用于临床［1］.为了探讨闭塞性脑血 管病血流动力学改变规律及其临床意义，我们将8 2例脑血管病患者 TCD检测结果与脑血管造影检查进行了对比分析，检验TCD与数字 减影脑血管造影(cerebral vascular angiography, CVA)的诊断符 合率，探讨TCD作为脑血管狭窄初步筛选的可靠程度.提升TCD检 测方法成为闭塞性脑血管病极早发现和预警，早期诊断和干预的有效 方法. 1对象和方法 1.1对象 空军总院患者8 2（男5 3,女2 9）例，年龄21?79（平均50）岁. 非闭塞性脑血管病组14（男1 1，女3）例，平均年龄4 4岁，包括有 蛛网膜下腔出血、血管畸形