中国临床康复
中國臨床康複
중국림상강복
CHINESE JOURNAL OF CLINICAL REHABILITATION
2005年
33期
142-143
,共2页
李国霖%刘巍松%毕胜%赵庆杰
李國霖%劉巍鬆%畢勝%趙慶傑
리국림%류외송%필성%조경걸
超声检查,多普勒,经颅%磁共振成像%血流动力学
超聲檢查,多普勒,經顱%磁共振成像%血流動力學
초성검사,다보륵,경로%자공진성상%혈류동역학
背景:血管造影虽为诊断脑血管病的"金标准",因其有创性不能广泛应用,经颅多普勒超声和头部磁共振血管成像均为无创检查,可用于颅内大动脉血管腔及血流动力学的评估.目的:探讨经颅多普勒超声评估缺血性脑血管病时血流动力学变化的可靠性及与磁共振血管成像的相关性.设计:以患者为观察对象,病例分析.单位:哈尔滨医科大学第一临床医学院神经内科.对象:以2001-04/2002-02哈尔滨医科大学第一临床医学院神经内科收治的脑卒中患者45例为观察对象,所有患者经CT证实为缺血性脑血管病,且对实验知情同意.方法:应用TC-2021经颅多普勒超声仪及VISART1.5T超导MR装置,对45例患者行经颅多普勒超声与磁共振血管成像检查,两次检查相隔时间为1～15 d.观察所检大脑中动脉、颈内动脉末端、大脑前动脉、大脑后动脉、椎动脉、基底动脉血管的血流动力学及管腔形态的变化.主要观察指标:①经颅多普勒超声和磁共振血管成像检查患者颅内血管腔和血流动力学结果的相关性.②以磁共振血管成像为标准,比较经颅多普勒超声检查的特异性,敏感性,假阳性,假阴性及符合率.结果:45例患者全部进入结果分析.①经颅多普勒超声和磁共振血管成像检测结果相关性:理论值:Tmin=9.91;χ2=107.92,P＜0.005,可认为两者检出率结果有关;经颅多普勒超声检出率为19.06%,磁共振血管成像检出率为15.25%,两者检出阳性率有差别(χ2=3.93,P＜0.05).②以磁共振血管成像为标准,比较经颅多普勒超声发现相应血管病变数,得出诊断异常血管的特异性为94.22%、敏感性为78.10%、假阳性为7.46%,假阴性为23.31%及符合率为89.36%.结论:经颅多普勒超声诊断缺血性脑血管病脑血管异与磁共振血管成像相符性较高,它能准确判定所探及血管功能状态,能较早而敏感反映脑血流动力学的变化.而磁共振血管成像则可直接显示血管形态的改变,两者结合可提高诊断的敏感性和特异性.
揹景:血管造影雖為診斷腦血管病的"金標準",因其有創性不能廣汎應用,經顱多普勒超聲和頭部磁共振血管成像均為無創檢查,可用于顱內大動脈血管腔及血流動力學的評估.目的:探討經顱多普勒超聲評估缺血性腦血管病時血流動力學變化的可靠性及與磁共振血管成像的相關性.設計:以患者為觀察對象,病例分析.單位:哈爾濱醫科大學第一臨床醫學院神經內科.對象:以2001-04/2002-02哈爾濱醫科大學第一臨床醫學院神經內科收治的腦卒中患者45例為觀察對象,所有患者經CT證實為缺血性腦血管病,且對實驗知情同意.方法:應用TC-2021經顱多普勒超聲儀及VISART1.5T超導MR裝置,對45例患者行經顱多普勒超聲與磁共振血管成像檢查,兩次檢查相隔時間為1～15 d.觀察所檢大腦中動脈、頸內動脈末耑、大腦前動脈、大腦後動脈、椎動脈、基底動脈血管的血流動力學及管腔形態的變化.主要觀察指標:①經顱多普勒超聲和磁共振血管成像檢查患者顱內血管腔和血流動力學結果的相關性.②以磁共振血管成像為標準,比較經顱多普勒超聲檢查的特異性,敏感性,假暘性,假陰性及符閤率.結果:45例患者全部進入結果分析.①經顱多普勒超聲和磁共振血管成像檢測結果相關性:理論值:Tmin=9.91;χ2=107.92,P＜0.005,可認為兩者檢齣率結果有關;經顱多普勒超聲檢齣率為19.06%,磁共振血管成像檢齣率為15.25%,兩者檢齣暘性率有差彆(χ2=3.93,P＜0.05).②以磁共振血管成像為標準,比較經顱多普勒超聲髮現相應血管病變數,得齣診斷異常血管的特異性為94.22%、敏感性為78.10%、假暘性為7.46%,假陰性為23.31%及符閤率為89.36%.結論:經顱多普勒超聲診斷缺血性腦血管病腦血管異與磁共振血管成像相符性較高,它能準確判定所探及血管功能狀態,能較早而敏感反映腦血流動力學的變化.而磁共振血管成像則可直接顯示血管形態的改變,兩者結閤可提高診斷的敏感性和特異性.
배경:혈관조영수위진단뇌혈관병적"금표준",인기유창성불능엄범응용,경로다보륵초성화두부자공진혈관성상균위무창검사,가용우로내대동맥혈관강급혈류동역학적평고.목적:탐토경로다보륵초성평고결혈성뇌혈관병시혈류동역학변화적가고성급여자공진혈관성상적상관성.설계:이환자위관찰대상,병례분석.단위:합이빈의과대학제일림상의학원신경내과.대상:이2001-04/2002-02합이빈의과대학제일림상의학원신경내과수치적뇌졸중환자45례위관찰대상,소유환자경CT증실위결혈성뇌혈관병,차대실험지정동의.방법:응용TC-2021경로다보륵초성의급VISART1.5T초도MR장치,대45례환자행경로다보륵초성여자공진혈관성상검사,량차검사상격시간위1～15 d.관찰소검대뇌중동맥、경내동맥말단、대뇌전동맥、대뇌후동맥、추동맥、기저동맥혈관적혈류동역학급관강형태적변화.주요관찰지표:①경로다보륵초성화자공진혈관성상검사환자로내혈관강화혈류동역학결과적상관성.②이자공진혈관성상위표준,비교경로다보륵초성검사적특이성,민감성,가양성,가음성급부합솔.결과:45례환자전부진입결과분석.①경로다보륵초성화자공진혈관성상검측결과상관성:이론치:Tmin=9.91;χ2=107.92,P＜0.005,가인위량자검출솔결과유관;경로다보륵초성검출솔위19.06%,자공진혈관성상검출솔위15.25%,량자검출양성솔유차별(χ2=3.93,P＜0.05).②이자공진혈관성상위표준,비교경로다보륵초성발현상응혈관병변수,득출진단이상혈관적특이성위94.22%、민감성위78.10%、가양성위7.46%,가음성위23.31%급부합솔위89.36%.결론:경로다보륵초성진단결혈성뇌혈관병뇌혈관이여자공진혈관성상상부성교고,타능준학판정소탐급혈관공능상태,능교조이민감반영뇌혈류동역학적변화.이자공진혈관성상칙가직접현시혈관형태적개변,량자결합가제고진단적민감성화특이성.
BACKGROUND: Although angiography is the gold standard for the diagnosis of cerebrovascular disease, it cannot be used widely because of its traumatotaxis. Transcranial Doppler ultrasound (TCD) and MRA are both non-invasive examinations, which can be used to evaluate intracranial large artery vascular trunks and hemodynamics.OBJECTIVE: To investigate the reliability of diagnosis with TCD on hemodynamic changes of ischemic cerebrovascular disease (ICVD) and the relativity between TCD and MRA.DESIGN: Case analysis based on patients.SETTING: Neurological Department of the First Affiliated Clinical Hos-pital, Harbin Medical University.PARTICIPANTS: From April 2001 to February 2002,totally 45 patients with stroke,selected from outpatients and inpatients of Neurological Department of First Affiliated Clinical Hospital of Harbin Medical University,examined by CT, to be told the fact and accepted, were taken part in the study.METHODS: Patients were examined with TC-2021 TCD instrument produced by German EME Corporation and VISART1.5T superconduct MR instrument produced by Toshiba. Totally 45 patients had TCD and MRI examinations, and the alternation between two examinations was 1 to 15 days. The hemodynamics and morphological changes were observed including middle cerebral artery (MCA), end of internal carotid artery (ICA),anterior cerebral artery (ACA), posterior cerebral artery (PCA), basal artery (BA), and vertebral artery (VA).large artery vascular trunks and hemodynamic results with TCD and MRA;ty, false positive and false negative with TCD with those of MRA.TCD and MRA: Theory data was Tmin=9.91; χ2=107.92, P ＜ 0.005, it was considered that the results with the rate of TCD were related with that of MRA. The detection rate of TCD was 19.06%, and that of MRA was 15.25%. There were significant differences between the detection rate of standard, the sensibility of diagnosing abnormal vessels by TCD was 78.10%, specificity 94.22%, false positive 7.46%, false negative 23.31%,and the coincidence rate 89.36%.CONCLUSION: TCD can assess exactly the functional status of the vessels. It can also reflect early and sensitively the change of hemodynamics of cerebral blood flow. While MRA can display the change of vascular appearance directly so that the combination of TCD and MRA will be improve sensibility and specificity of diagnosis.
