TCD与MRA对缺血性脑血管病脑动脉狭窄检出率的对比分析

缺血性脑血管病是神经内科常见病,经颅多普勒超声（transcranial Doppler ultrasound．TCD）和磁共振血管成像（magnetic resonance angiograghy,MRA）检查技术对缺血性脑血管病具有很高的临床诊断价值。     

TCD在脑动脉狭窄诊断中的价值探讨

目的：讨论TCD经颅多普勒超声（Transcranial Doppler Ultronography）在脑动脉狭窄诊断中的价值。方法：选择2011-01～2012-01期间在我院住院的因患缺血性脑血管病的70位患者进行TCD及数字减影血管造影的检查,并将结果进行统计和分析。对TCD诊断脑动脉狭窄缺血性脑血管病的准确定以及敏感性探讨临床应用价值。结果：TCD诊断对颅内动脉狭窄诊断的可靠性较好。结论：TCD对脑动脉狭窄确实是一种有效的检查手段,但是TCD和DSA互补应用可以为脑血管疾病的诊治提供良好的客观依据。     

经颅多普勒超声在高血压病各期中的监测应用

对100例高血压病各期患者的TCD结果进行分析，并与脑电图、脑地形图、X线电算体层成像进行对比研究，结果表明：经颅多普勒超声检查在高血压病早期即出现显著异常，伴随高血压病情进展而呈递增趋势，而脑电图．恼地形图、X线电算体昙成像的敏感性则相对较差，经颅多普勒超声辁查对于诊治高血压病、预报和防治脑血管病的发生具有重要价值。     

糖尿病患者的经颅多普勒变化

目的:应用经颅多普勒检查糖尿病患者颅内血管状况,以了解糖尿病与血液动力学变化的关系。方法:采用德国EME公司2020型经颅多普勒检查仪。对55例糖尿病患者及60例健康对照组进行了经颅多普勒检查,观察大脑中动脉、大脑前动脉、大脑后动脉,椎、基底动脉的血流速度,搏动指数及血流频谱进行检测。结果:55例糖尿病患者中血流速度异常占81.82%,其中血管痉挛8例,血管硬化30例,血管狭窄7例,正常10例。两组搏动指数值比较,糖尿病组搏动指数值显著高于健康对照组。结论:经颅多普勒超声检查可以较明确反映糖尿病脑血管病变的部位、范围和性质。     

彩色多普勒超声在甲状旁腺腺瘤诊断中的应用价值

目的:探讨彩色多普勒超声(CDUS)诊断甲状旁腺腺瘤(PTA)的应用价值。方法:应用彩色多普勒超声诊断仪检查10例PTA患者,全部病例经手术病理证实。结果:10例患者经彩色多普勒超声发现甲状旁腺实性肿块11个,经手术证实为PTA的有10个,增生性病灶1个,其中CDUS第一诊断拟诊为PTA的有7例,另有3例第一诊断为甲状腺腺瘤。结论:彩色多普勒超声可以比较准确的诊断PTA。     

脑缺血患者脑CT与多普勒超声诊断的对比研究

对64例脑梗塞和31例短暂性脑缺血发作患者进行了颅内动脉和颅外颈功脉联合多普勒超声检查,并与脑 CT 诊断做了对比研究,发现多普勒超声诊断的阳性率明显高于脑 CT 诊断的阳性率,并且对确定是否存在颈动脉狭窄所致的未梢性低灌流状态和脑梗塞后脑缺血缺氧乳酸血症所致的过渡灌流状态有较高的特异性,对治疗有指导意义。     

彩色多普勒超声对剖宫产瘢痕妊娠的诊断价值

目的探讨经阴道彩色多普勒超声对诊断子宫切口妊娠的应用价值。方法选取2004年1月至2008年12月间因剖宫产后早孕要求终止妊娠的19例患者,运用经阴道彩色多普勒超声检查。结果经阴道彩色多普勒超声检查,对17例诊断为子宫切口妊娠及2例误诊的病例,诊断准确率为89.5％。结论经阴道彩色多普勒超声检查对诊断子宫切121妊娠有较高的临床应用价值。     

彩色多普勒超声诊断脑血管病颈动脉粥样硬化的临床价值

脑血管疾病早期诊断及合理的治疗方法,对改善患者预后具有十分重要的意义[1].彩色多普勒超声学检查脑血管病变的评价中有一定的优势[2].本文通过对脑血管病患者临床资料的分析,探讨彩色多普勒超声应用于脑血管病颈动脉粥样硬化诊断的临床价值.     

老年高血压患者心电图与经颅多普勒超声对比分析

目的 :探讨老年高血压患者心电图与经颅多普勒超声检查的关系。方法 :应用心电图仪和彩色经颅多普勒超声检查仪 (throughcraniumDoppler,TCD)对 5 8例非老年高血压患者、89例老年高血压患者进行检测 ,观察心脏损害与脑动脉血流动力学变化的关系。结果 :老年高血压患者心电图异常率 ( 75 .7% )显著高于非老年高血压患者 ( 2 2 .9% ) ;TCD异常率 ( 92 .2 % )较非老年高血压患者组 ( 9.8% )增高 (P <0 .0 5 )。老年高血压病史与心电图、TCD的异常呈正相关。结论 :心电图与TCD检查相结合对老年高血压患者的心、脑血管病变的诊断防治有较好的实用价值。     

经颅彩色双功超声在脑血管疾病中的临床应用和进展

经颅彩色双功超声是一种新型、无创的超声诊断仪,高空间分辨率显示颅内血管和脑实质的结构,笔者查阅了近年来相关文献,主要综述经颅彩色多普勒血流显像在颅脑血管疾病中的诊断价值,同时讨论二维经颅超声的应用及新的实验性显像技术。     

Transcranial Doppler ultrasonography in neurologically asymptomatic children and young adults with sickle cell disease

The purpose of the study was to evaluate transcranial Doppler ultrasonography for identifying cerebrovascular disease in neurologically asymptomatic children and young adults with sickle cell disease. A total of 47 consecutive patients with sickle cell disease (28 females, 19 males; age range 8 months to 29 years, mean age 9 years 6 months) were evaluated by transcranial color and duplex Doppler ultrasonography via transtemporal and occipital (2-MHz probe) as well as by transocular (5-MHz probe) approach. Eleven vessels (middle, posterior, anterior cerebral artery, vertebral artery, ophthalmic artery on each side and basilar artery) were analyzed in each patient. Following nine transcranial Doppler findings predictive for cerebrovascular disease, patients with one or more of those abnormal sonographic findings underwent MR imaging and MR angiography. In 8 patients with abnormal transcranial Doppler the MR angiography was normal. Thirty-one patients demonstrated normal results. In 15 of 16 patients with one or more abnormal Doppler findings (34% of all studied patients) MR imaging and MR angiography were performed. The MR angiography disclosed cerebrovascular stenosis in 7 patients (15% of all patients, 44% of those with pathological transcranial Doppler findings). In one of those patients MR imaging revealed silent peripheral ischemic infarction as well. Our findings indicate the usefulness of transcranial Doppler ultrasonography to reveal occult cerebrovascular lesions in neurologically asymptomatic patients with sickle cell disease. It should regularly be performed in all sickle cell patients in order to detect patients at risk for later stroke. Patients with homozygous disease and a high frequency of preceding sickle cell crises should be followed most closely. Electronic Publication     

缺血性脑血管病患者颈动脉粥样硬化与胰岛素抵抗的相关性研究

目的 :应用彩色多普勒超声检测颈动脉粥样硬化 ,确定缺血性脑血管病与胰岛素抵抗之间的关系。方法 :颈内动脉系短暂脑缺血发作患者 5 0例 ,脑梗塞患者 70例 ,根据糖耐量试验分为胰岛素抵抗组与非胰岛素抵抗组 ,分别应用超声检测颈动脉粥样硬化情况。结果 :胰岛素抵抗组颈动脉异常率 78% ,非胰岛素抵抗组颈动脉异常率为 4 0 .5 % ,P <0 .0 5 ,两组间有显著性差异。结论 :缺血性脑血管病患者胰岛素抵抗与颈动脉粥样硬化密切相关 ,表明胰岛素抵抗是缺血性脑血管病的一个重要的危险因素     

彩色多普勒超声在颈动脉粥样硬化诊断中的应用

目的和方法 对60例分别有高血压(26例)、冠心病(20例)、脑梗塞(10例，其中高血压、冠心病合并脑梗塞8例)，脑供血不足(4例)患做颈动脉超声检查，探讨彩色多普勒超声在颈动脉粥样硬化(CAS)诊断中的应用价值。结果 60例患均有程度不等的颈动脉粥样硬化形成，其中16例为单纯内膜一中层厚度增厚，44例有粥样硬化斑块形成，占73．3％。CAS斑块好发于颈总动脉分叉处，以扁平斑多见，软斑、硬斑次之，溃疡斑最少。结论 彩色多普勒超声检测颈动脉粥样硬化有重要的临床应用价值。     

TCD新指标对糖尿病脑血管病变的诊断价值

目的：研究TCD新指标对诊断糖尿病脑血管病变的价值。方法：65例糖尿病患者和80例健康者,采用TCD技术与计算机连用方法,对以上两组145例的1595条脑血管进行新指标的对照检测。／结果：95．84％患者脑血管出现明显异常。与原指标相比,测试的临床确诊率提高了30．16％,结论：脑血管收缩平均速度,反弹高度,紧张度,压力指数,缓慢指数,脑负荷指数,是多方位反遇糖尿病脑血管病变的重要参数和新指标,对临床诊断糖尿病脑血管病有重要价值。     

2型糖尿病患者合并缺血性脑血管病的相关危险因素分析

目的探讨2型糖尿病（T2DM）患者发生缺血性脑血管病的危险因素。方法选取120例T2DM患者,其中合并缺血性脑血管病变者51例,无缺血性脑血管病变者69例,检测相关指标并进行分析。结果两组相比,DM病程、吸烟史、HDL-C、FPG、HbA1C、血压、高敏C反应蛋白（hsC-RP）存在统计学差异（P〈0.05或P〈0.01）。多因素回归分析显示糖尿病病程、FPG、hsC-RP与T2DM合并缺血性脑血管病呈正相关（P〈0.05或P〈0.01）。结论 hsC-RP、FPG和糖尿病病程是促使T2DM并发缺血性脑血管病的独立危险因素。     

Color flow Doppler characterization of focal hepatic lesions.

OBJECTIVE. The purpose of this study was to determine the sensitivity and specificity of color flow Doppler sonography for the specific diagnosis of focal hepatic lesions. SUBJECTS AND METHODS. Color flow Doppler images of 118 focal hepatic lesions in 108 patients were analyzed prospectively. In most patients, liver disease was suspected or known to be present before the Doppler images were obtained. Experienced sonologists obtained and interpreted all sonograms. The lesions were classified, according to their color flow pattern, into two main categories: lesions with internal vascularity and lesions with no internal vascularity. The color flow Doppler pattern of each lesion was correlated with the diagnosis of the lesion on a lesion-by-lesion basis. One hundred two lesions were proved by biopsy and 16 lesions were confirmed by evaluation with other imaging techniques. Lesions included 29 hepatocellular carcinomas, 64 metastases, one cholangiocarcinoma, and 24 benign lesions. The sensitivity and specificity of vascularity as shown by color Doppler imaging in the diagnosis of hepatocellular carcinoma were determined. RESULTS. The majority of hepatocellular carcinoma lesions (76%) had internal vascularity. Most of the metastases (67%) and benign lesions (75%) had no internal vascularity. When the presence of internal vascularity was used as the discriminating criterion, the sensitivity of color flow Doppler findings for the diagnosis of hepatocellular carcinoma was 0.76. The specificity of internal vascularity for the diagnosis of hepatocellular carcinoma vs other focal lesions was 0.69; for hepatocellular carcinoma vs metastases it was 0.67. CONCLUSION. Although most hepatocellular carcinomas have internal vascularity on color flow Doppler images, a significant number of metastases also have internal vascularity. This overlap limits the usefulness of color flow Doppler imaging for distinguishing hepatocellular carcinoma from metastatic tumors.     

颈部血管彩超对缺血性脑血管病患者颈部动脉血管病变的诊断价值

目的探讨颈部血管彩超对缺血性脑血管病患者颈部动脉血管病变的诊断价值。方法 51例经头部CT或MRI及临床确诊的缺血性脑血管病患者,均进行了多层螺旋CT血管成像（CTA）和颈部血管超声（CVUS）检查,以CTA为对照,评价颈部血管彩超的诊断价值。结果 CTA和CVUS发现颈动脉狭窄及闭塞分别为20例、17例,椎动脉狭窄或发育异常分别为29例、15例。结论对于颈动脉狭窄的评价,颈部血管彩超和CTA具有很好的一致性,但颈部血管彩超对椎动脉病变的评价不足,联合使用CVUS和CTA可以更全面地评价缺血性脑血管病患者的颈部动脉病变。     

Blood-flow volume quantification in internal carotid and vertebral arteries: comparison of 3 different ultrasound techniques with phase-contrast MR imaging

BACKGROUND AND PURPOSE: Optimal estimation of cerebral blood-flow volume (BFV) may be an important indicator for better evaluation of the patients with cerebrovascular disorders. In this study, we compared the BFV values at bilateral internal carotid and vertebral arteries of healthy volunteers obtained with color Doppler, power Doppler, and B-flow ultrasound (US) studies and tried to determine which examination is more correlated with MR phase-contrast quantification. METHODS: BFVs of the internal carotid and vertebral arteries of 40 healthy volunteers (19 men and 21 women; age range, 20-47 years) were measured by using color Doppler, power Doppler, B-flow US and MR phase-contrast imaging. The flow measurements obtained with the sonographic techniques were compared with MR phase contrast, which is accepted as the most reliable method for the estimation of cerebral BFV. RESULTS: Quantification with power Doppler imaging showed the highest values among sonography techniques, followed by color Doppler imaging, B-flow imaging (BFI), and MR phase-contrast flow quantification. There was a statistically significant difference between the flow-volume values obtained with these 4 different techniques (P < .05). BFI yielded the closest values (internal carotid arteries, 238.84 mL/min; vertebral arteries, 51.16 mL/min) to MR phase-contrast flow quantification study with higher correlation rates. CONCLUSION: Flow volumes obtained with BFI showed the highest correlation with MR phase-contrast imaging among 3 different sonography techniques. B-flow sonography may be a very effective and cost-efficient alternative for MR phase-contrast studies for the calculation of cerebral BFV.     

140例脑血管病经颅多普勒分析

目的:分析经颅多普勒(Trans-Cranial Doppler,TCD)对急性脑血管病的诊断敏感性。材料与方法:140例脑血管病患者,其中男76例,女64例,年龄20～85岁,于入院3天内均接受了TCD检查。除7例短暂性脑缺血发作者外,其余133例患者包括41例脑出血,84例脑梗塞,以及8例蛛网膜下腔出血,还经CT或腰穿证实。使用的超声诊断仪为美国产Medasonics彩色多普勒。结果:TCD较准确而及时地显示了脑血管狭窄、痉挛、闭塞,以及血管壁弹性降低等血管病变。急性脑血管病的TCD异常表现及异常率随不同病种而异,例如,脑出血主要表现为脑血管痉挛和狭窄,搏动指数升高,频谱异常,异常率82.9％,脑梗塞——脑血管严重狭窄或闭塞,频谱异常,异常率95.2％,蛛网膜下腔出血——于发病后1～7天内出现的血管痉挛是其主要伴发症,异常率62.5％,短暂性脑缺血发作——其表现相似于脑梗塞,异常率85.7％。结论:TCD对颅内动脉系统及椎一基底动脉系统的血管病变均能及时显示并准确定位。因此,它不仅对急性脑血管病具有很高的诊断敏感性,而且可用于评价某些药物的临床疗效或追踪观察。     

彩色多普勒超声对颈动脉-海绵窦瘘的诊断价值

目的探讨彩色多普勒超声（CDUS）对颈动脉-海绵窦瘘（CCF）的诊断价值。方法本文应用CDUS对6例CCF患者进行了分析,并与脑血管造影比较。结果CDUS显示,引流静脉多以扩张的眼上静脉为主,脉冲多普勒可测到连续层流的静脉频谱中混叠有动脉搏动性频谱,患侧颈内动脉流速明显高于健侧;患侧大脑中动脉（MCA）、大脑前动脉（ACA）流速低于健侧。压迫患侧颈总动脉,患侧颈内动脉（瘘口以上）出现不同程度的倒灌血流。结论彩色多普勒超声对颈动脉-海绵窦瘘的诊断具有高度的特异性,是一项值得临床推广应用的无创、方便、快捷的诊断颈动脉-海绵窦瘘的辅助检查方法。