北京医学
北京醫學
북경의학
BEIJING MEDICAL JOURNAL
2014年
5期
354-357
,共4页
朱惠萍%李常红%张燕辉%冯浩%于逢春
硃惠萍%李常紅%張燕輝%馮浩%于逢春
주혜평%리상홍%장연휘%풍호%우봉춘
后循环缺血%彩色多普勒超声%经颅多普勒超声%CT血管成像
後循環缺血%綵色多普勒超聲%經顱多普勒超聲%CT血管成像
후순배결혈%채색다보륵초성%경로다보륵초성%CT혈관성상
Posterior circulation ischemia(PCI)%Colour Doppler ultrasound(CDU)%Transcranial Doppler%CT angiography(CTA)
目的：探讨颈动脉彩色多普勒超声（colour doppler ultrasound, CDU）、经颅多普勒超声（transcranial doppler, TCD）、CT血管成像（CT angiography, CTA）检查对后循环缺血（posterior circulation ischemia, PCI）血管评估的诊断价值。方法将216例PCI患者分为脑梗死组（86例）和短暂性脑缺血发作（TIA）组（130例），均行颈动脉CDU、TCD及头颈联合CTA检查，比较两组斑块的稳定性及血管狭窄的部位和程度。结果 CTA显示157例（72.7%）298条脑血管异常；后循环血管病变以椎动脉V1段（21.5%）和V4段（17.4%）狭窄最为多见，狭窄程度以重度（47.0%）为主；脑梗死组血管病变发生率为80.2%，高于TIA组的67.7%，脑梗死组血管重度狭窄的比例亦高于 TIA组（47.4%vs.25.4%），两者差异均有统计学意义（P<0.05）。132例（61.1%）颈动脉CDU异常；脑梗死组易损斑块的发生率为67.4%，高于TIA组的54.5%，差异有统计学意义（P<0.05）。148例（68.5%）TCD检查异常；脑梗死组侧支循环开放率较TIA组明显减少（19.8%vs.27.7%），差异有统计学意义（P<0.05）。结论 PCI患者的主要血管病变部位在椎动脉V1段和V4段；颈动脉CDU、TCD和CTA联合应用可为PCI的血管评估提供依据。
目的：探討頸動脈綵色多普勒超聲（colour doppler ultrasound, CDU）、經顱多普勒超聲（transcranial doppler, TCD）、CT血管成像（CT angiography, CTA）檢查對後循環缺血（posterior circulation ischemia, PCI）血管評估的診斷價值。方法將216例PCI患者分為腦梗死組（86例）和短暫性腦缺血髮作（TIA）組（130例），均行頸動脈CDU、TCD及頭頸聯閤CTA檢查，比較兩組斑塊的穩定性及血管狹窄的部位和程度。結果 CTA顯示157例（72.7%）298條腦血管異常；後循環血管病變以椎動脈V1段（21.5%）和V4段（17.4%）狹窄最為多見，狹窄程度以重度（47.0%）為主；腦梗死組血管病變髮生率為80.2%，高于TIA組的67.7%，腦梗死組血管重度狹窄的比例亦高于 TIA組（47.4%vs.25.4%），兩者差異均有統計學意義（P<0.05）。132例（61.1%）頸動脈CDU異常；腦梗死組易損斑塊的髮生率為67.4%，高于TIA組的54.5%，差異有統計學意義（P<0.05）。148例（68.5%）TCD檢查異常；腦梗死組側支循環開放率較TIA組明顯減少（19.8%vs.27.7%），差異有統計學意義（P<0.05）。結論 PCI患者的主要血管病變部位在椎動脈V1段和V4段；頸動脈CDU、TCD和CTA聯閤應用可為PCI的血管評估提供依據。
목적：탐토경동맥채색다보륵초성（colour doppler ultrasound, CDU）、경로다보륵초성（transcranial doppler, TCD）、CT혈관성상（CT angiography, CTA）검사대후순배결혈（posterior circulation ischemia, PCI）혈관평고적진단개치。방법장216례PCI환자분위뇌경사조（86례）화단잠성뇌결혈발작（TIA）조（130례），균행경동맥CDU、TCD급두경연합CTA검사，비교량조반괴적은정성급혈관협착적부위화정도。결과 CTA현시157례（72.7%）298조뇌혈관이상；후순배혈관병변이추동맥V1단（21.5%）화V4단（17.4%）협착최위다견，협착정도이중도（47.0%）위주；뇌경사조혈관병변발생솔위80.2%，고우TIA조적67.7%，뇌경사조혈관중도협착적비례역고우 TIA조（47.4%vs.25.4%），량자차이균유통계학의의（P<0.05）。132례（61.1%）경동맥CDU이상；뇌경사조역손반괴적발생솔위67.4%，고우TIA조적54.5%，차이유통계학의의（P<0.05）。148례（68.5%）TCD검사이상；뇌경사조측지순배개방솔교TIA조명현감소（19.8%vs.27.7%），차이유통계학의의（P<0.05）。결론 PCI환자적주요혈관병변부위재추동맥V1단화V4단；경동맥CDU、TCD화CTA연합응용가위PCI적혈관평고제공의거。
Objective To study the value of colour doppler ultrasound (CDU), transcranial Doppler (TCD) and CT angiography (CTA) in the clinical diagnosis of the posterior circulation ischemia (PCI). Methods A total of 216 patients with PCI were divided into the infarction group (n=86) and the TIA group (n=130). CDU and TCD was detected and con-firmed by CT angiography (CTA). The location, nature and extent of the vascular lesions were analyzed. Results CTA showed that totally 157 patients suffered from 298 cerebral vascular disease. The vascular stenosis incidence was 72.7%in patients with posterior circulation ischemia (PCI). The main posterior circulation lesions were located at the first segment (V1) (21.5%) and intracranial segment of VA(V4) ( 17.4%). The stenosis degree was severe (61.7%) in the vascular lesions. The incidence of vascular lesions was 80.2%in the infarction group. It was higher than that in the TIA group (67.7%). The incidence of severe vascular stenosis was 47.4%in the infarction group. It was higher than that in the TIA group (25.4%). The difference was statistically significant (P<0.05). Abnormalities of carotid arteries were detected by CDU in 132 cases (61.1%). The incidence of vulnerable plague was 67.4% in the infarction group. It was higher than that in the TIA group (54.5%). The difference was statistical significant (P<0.05). Abnormalities of arteries were detected by TCD in 148 cases (68.5%). The incidence of collateral circulation in the infarction group was 19.8%, which was lower than that of the TIA group (27.7%). The difference was statistical significant (P<0.05). Conclusion The main locations of vascular lesions in PCI patients are extracranial vertebral artery (V1) and intracranial VA (V4). Ultrasonography, TCD and CTA are useful in the evaluation of the etiological factors of PCI.
