经颅超声造影在缺血性脑血管病诊断中的应用研究

Study on application of CE-TCCS in the diagnosis of ICVD

关键词:  缺血性脑血管病  经颅超声造影  计算机断层血管造影成像

Key words:  [Key words]　 ICVD  CE-TCCS  CTA

摘要:

目的　探讨经颅超声造影(CE-TCCS)在诊断缺血性脑血管病（ischemic cerebrovascular disease，ICVD）中的应用价值。方法　对81例ICVD患者颅内血管行常规超声及CE-TCCS检查。观察超声造影前后颅内动脉显示情况，并记录造影前后大脑前动脉(aurterior cerebral artery,ACA)、大脑中动脉（middle cerebral artery,MCA）双椎动脉(vertebral artery,VA)和基底动脉(basilar artery,BA)血流频谱参数，将造影前后各大血管显示情况和血流参数分别进行对比分析；将超声检查结果与计算机断层血管造影成像(CTA)对照。结果　CE-TCCS明显提高MCA、ACA、VA及BV显示率（P<0.05），VA及BV造影后收缩期峰值速度(peak systolic velocity,Vp)、舒张末期流速(diastolic velocity,Vd)、平均流速(the average velocity,Vm)、达峰时间(time,T)均明显高于造影前（P<0.05），常规超声诊断ICVD颅内动脉血管狭窄或闭塞的准确性明显低于CTA（P<0.05）。CE-TCCS诊断ICVD颅内动脉血管狭窄或闭塞的准确性与CTA相近(P>0.05)。结论　CE-TCCS可以明显提高颅内动脉的显示率，可以更准确地提示ICVD患者的颅内血管狭窄或闭塞病变，且与CTA诊断结果的一致性较好。

Abstract:

[Abstract] Objective　To evaluate the application of CE-TCCS in the diagnosis of ICVD. Methods　CE-TCCS and conventional ultrasound were performed in 81 patients with ICVD. The display of intracranial artery was observed. The blood flow spectrum parameters of anterior, middle cerebral arteries, the vertebral and basilar arteries before and after the contrast were recorded. All the ultrasound findings were compared with CTA. Results　After CE-TCCS, the presentation of MCA，ACA，VA and BV were improved（P<0.05）. Vp, Vd, Vm, T of VA and BV were raised（P<0.05）. The Diagnosis accuracy rate of conventional ultrasound in diagnosing intracalvarium artery stenosis or occlusion in patients with ICVD was lower than that of CTA（P<0.05）.The Diagnosis accuracy rates of CE-TCCS and CTA were similar in diagnosing intracalvarium artery stenosis or occlusion in patients with ICVD (P>0.05). Conclusion　CE-TCCS can significantly improve the presentation of the intracranial arteries，can more accurately diagnose intracalvarium artery stenosis or occlusion in patients with ICVD, and is consistent with the CTA.