CAJ | 학술논문

目的：探讨彩色多普勒超声（CDFI）联合全脑数字减影血管造影（DSA）对脑分水岭梗死患者颅外段动脉评价中的作用。方法分析本院2008年1月至2011年12月的92例脑分水岭梗死患者的临床及影像学资料，比较颈部 CDFI 及 DSA 两种检查手段对颅外段动脉评价中的优缺点；比较皮质分水岭梗死和内分水岭梗死的颅外段血管病变情况。结果对92例552条血管进行检查， DSA 共发现52条血管狭窄，8条血管闭塞；CDFI 共发现有64条血管狭窄，12条血管闭塞。两者总体对血管狭窄及闭塞的诊断比较差异无统计学意义（P＞0．05）。对于动脉粥样硬化斑块性质的判断，两者之间比较差异有统计学意义（P＜0．05）。皮质分水岭梗死与内分水岭在动脉狭窄或闭塞及不稳定斑块方面差异有统计学意义（P＜0．05）。结论CDFI及 DSA 对分水岭脑梗死颅外段供血动脉病变的判断具有重要意义且各具优缺点：DSA 是诊断血管狭窄或闭塞的金标准，但对动脉硬化斑块性质的判断存在局限性；彩超能准确判断动脉粥样硬化斑块性质，但对血管狭窄或闭塞的判断存在一定的假阳性率。联合应用有助于对患者颅外段动脉的评价。
목적：탐토채색다보륵초성（CDFI）연합전뇌수자감영혈관조영（DSA）대뇌분수령경사환자로외단동맥평개중적작용。방법분석본원2008년1월지2011년12월적92례뇌분수령경사환자적림상급영상학자료，비교경부 CDFI 급 DSA 량충검사수단대로외단동맥평개중적우결점；비교피질분수령경사화내분수령경사적로외단혈관병변정황。결과대92례552조혈관진행검사， DSA 공발현52조혈관협착，8조혈관폐새；CDFI 공발현유64조혈관협착，12조혈관폐새。량자총체대혈관협착급폐새적진단비교차이무통계학의의（P＞0．05）。대우동맥죽양경화반괴성질적판단，량자지간비교차이유통계학의의（P＜0．05）。피질분수령경사여내분수령재동맥협착혹폐새급불은정반괴방면차이유통계학의의（P＜0．05）。결론CDFI급 DSA 대분수령뇌경사로외단공혈동맥병변적판단구유중요의의차각구우결점：DSA 시진단혈관협착혹폐새적금표준，단대동맥경화반괴성질적판단존재국한성；채초능준학판단동맥죽양경화반괴성질，단대혈관협착혹폐새적판단존재일정적가양성솔。연합응용유조우대환자로외단동맥적평개。
[ Abstract] Objective To study the value of color Doppler imaging ( CDFI) and digital subtraction angiography(DSA) in the evaluation of extracranial arteries in patients with cerebral watershed infarction.Methods Analyze the clinical and imaging data of 92 cases of cerebral watershed infarction patients during the period from 2008 January to 2011 December.Analyzed the clinical value of color Doppler and DSA on the evaluation of extracranial arteries and compared the advantages and disadvantages of the two ways.Results We examined 552 neck arteries in the 92 patients , 52 artery moderate or severe stenosis and 8 artery occlusion were confirmed by DSA. By CDFI way, 64 artery stenosis and 12 artery occlusion were confirmed.The overall showed no significant difference in the diagnosis of vascular stenosis and occlusion (P>0.05).For the character of atherosclerotic plaques, The results showed that CDFI is superior to DSA (P<0.05).between internal watershed and cortical watershed infarction, there were significant differences in unstable atherosclerotic plaque and arterial stenosis or occlusion ( P <0.05). Conclusion It is significant of CDFI and DSA to judge the extracranial arteries lesions in patients with cerebral watershed infarction.The two ways both have advantages and disadvantages.DSA is the gold standard in the diagnosis of arteries stenosis or occlusion but has limitations in judgment of the character of the atherosclerotic plaques; can ac-curately judge the signal of atherosclerosis plaques, but has certain false positive rate in judgment of the arteries ste-nosis or occlusion .To combine the two ways is help for judging the disease and choosing the correct treatment.