TCD定量评价ICA狭窄致缺血性卒中患者侧支循环的研究

doi:10.7517/issn.1674-0475.220108

摘要/Abstract

摘要： 本研究探讨临床上应用经颅多普勒（TCD）定量评价颈内动脉（ICA）狭窄致缺血性脑卒中患者侧支循环建立及神经功能康复效果的价值。选取经数字剪影血管造影（DSA）确诊的单侧ICA狭窄或闭塞致缺血性脑卒中患者138例，所有患者均接受TCD检查，以DSA作为金标准，评估TCD诊断患者侧支循环建立的价值；TCD诊断前交通动脉、后交通动脉、眼动脉的侧支循环开放与DSA的符合率分别为91.53%、90.91%、86.05%；诊断单侧ICA狭窄或闭塞致缺血性脑卒中患者侧支循环的诊断灵敏度为89.88%、特异度为90.65%；138例单侧ICA狭窄或闭塞致缺血性脑卒中患者，其中侧支循环良好的患者有60例、侧支循不良的患者有78例，良好组患者的TCD量化评分显著高于不良组（P<0.05）；且脑CBF、CBV值均显著大于不良组（P<0.05），而脑MTT、TTP值均显著小于不良组（P<0.05）。临床上采用TCD诊断与定量评估ICA狭窄致缺血性脑卒中患者侧支循环建立情况具有较高的准确性，且可以通过TCD量化评估侧支循环建立情况对患者神经功能缺损程度及恢复情况进行判断。

关键词: 经颅多普勒, 定量, 颈内动脉狭窄, 缺血性脑, 侧支循环

Abstract: This study investigated the value of clinical application of transcranial Doppler (TCD) to quantitatively evaluate the establishment of collateral circulation and neurological rehabilitation in patients with ischemic stroke caused by internal carotid artery (ICA) stenosis. 138 patients with ischemic stroke caused by unilateral ICA stenosis or occlusion diagnosed by digital silhouette angiography (DSA) were selected as research objects, and all patients underwent TCD examination. DSA was used as the gold standard to evaluate the value of TCD in diagnosing the establishment of collateral circulation in patients. The coincidence rates of TCD in diagnosing collateral circulation of anterior communicating artery, posterior communicating artery and ophthalmic artery with DSA were 91.53%, 90.91% and 86.05%, respectively. The diagnostic sensitivity and specificity of diagnosing collateral circulation in patients with ischemic stroke caused by unilateral ICA stenosis or occlusion were 89.88% and 90.65%. Among 138 patients with ischemic stroke caused by unilateral ICA stenosis or occlusion, including 60 patients with good collateral circulation and 78 patients with poor collateral circulation, the TCD quantitative score of the patients in the good group was significantly higher than that in the poor group (P<0.05). The brain CBF and CBV values were higher than those of the poor group (P<0.05), while the brain MTT and TTP values were lower than those of the unhealthy group (P<0.05). Clinically, TCD Diagnosis and quantitative evaluation of the establishment of collateral circulation in patients with ischemic stroke caused by ICA stenosis has a high accuracy, and the establishment of collateral circulation can be quantitatively evaluated by TCD to judge the degree of neurological deficit and recovery.

Key words: transcranial doppler, quantitative, internal carotid artery stenosis, ischemic brain, collateral circulation

刘辉明, 胡高智. TCD定量评价ICA狭窄致缺血性卒中患者侧支循环的研究[J]. 影像科学与光化学, 2022, 40(4): 821-825.

LIU Huiming, HU Gaozhi. The Study on TCD Quantitative Evaluation of Collateral Circulation in Patients with Ischemic Stroke Caused by ICA Stenosis[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(4): 821-825.

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