经颅彩色多普勒超声对颅内段椎动脉狭窄血流动力学的评价标准

发布时间：2018-06-13 11:52

  本文选题：颅内段椎动脉狭窄 + 经颅彩色多普勒超声　； 参考：《中国脑血管病杂志》2015年08期

【摘要】：目的探讨经颅彩色多普勒超声(TCCS)诊断颅内段椎动脉狭窄的血流动力学参数标准。方法回顾性纳入622例门诊或住院可疑后循环缺血患者,从中选取经TCCS、彩色多普勒血流显像(CDFI)筛查和DSA检查的患者共216例,其中颅内椎动脉正常者33例(15.3%),狭窄率50%者45例(20.8%),狭窄率为50%~69%者44例(20.4%),狭窄率为70%~99%者94例(43.5%)。通过检测颅内段椎动脉、椎间隙段收缩期峰值流速(PSV1、PSV2)和舒张期末流速(EDV1、EDV2),分别计算颅内段平均流速(MV)、颅内段与椎间隙段收缩期峰值流速、舒张期末流速的比值SPRP(PSV1/PSV2)、SPRE(EDV1/EDV2)。以DSA检查结果为标准,计算受试者工作特征(ROC)曲线下面积,获得最佳截断点。结果 TCCS诊断颅内段椎动脉狭窄血流动力学参数最佳截断点分别为:狭窄率50%的参数标准为110 cm/s≤PSV1≤145 cm/s,65 cm/s≤MV≤85 cm/s;狭窄率为50%~69%的参数标准为145 cm/s≤PSV1≤190 cm/s,85 cm/s≤MV≤115 cm/s;狭窄率为70%~99%的参数标准为PSV1≥190 cm/s,MV≥115 cm/s。结论 TCCS可有效评价颅内段椎动脉狭窄的血流动力学变化,为颅内段椎动脉狭窄的超声评判标准提供参考。
[Abstract]:Objective to investigate the criteria of hemodynamic parameters for diagnosis of intracranial vertebral artery stenosis by transcranial color Doppler ultrasound (TCCS). Methods A total of 622 patients with suspected posterior circulation ischemia were enrolled retrospectively. 216 patients were screened by TCCS, CDFI by color Doppler flow imaging (CDFI) and examined by DSA. Among them, there were 33 cases with normal intracranial vertebral artery, 45 cases with 50% stenosis, 44 cases with 20.4% with 50% stenosis, and 94 cases with 43.5% stenosis. The peak systolic velocity (PSV1PSV2) and the end-diastolic velocity (EDV1 / EDV2) of intracranial vertebral artery and intervertebral space were measured, respectively. The mean flow velocity of intracranial segment and the ratio of peak systolic velocity of intracranial segment to intervertebral segment, the ratio of peak systolic velocity of intracranial segment to intervertebral segment, and the ratio of peak systolic velocity of intracranial segment to intervertebral segment and end-diastolic velocity of PSV1 / PSV2EDV2 were calculated respectively. The area under the ROC curve was calculated according to DSA results and the optimum truncation point was obtained. Results the best truncation points of hemodynamic parameters for diagnosis of intracranial vertebral artery stenosis were as follows: the parameter standard of 50% stenosis rate was 110 cm/s 鈮，

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