经颅彩色多普勒超声造影在颞骨声窗受限的脑梗死患者颅内侧支循环评价中的应用

目的 探讨经颅彩色多普勒超声造影 （contrast-enhanced transcranial color-coded doppler， CE-TCCD） 技术在判断颞骨声窗受限的脑梗死及短暂性脑缺血发作 （transient ischemic attack， TIA） 患者颅内侧支循环方面的应用。方法 选择由于声窗的限制， 经颅彩色多普勒超声检查未探及颅内血流信号的70例脑梗死及TIA患者， 应用CE-TCCD检测其颅内血流及Willis环的开放情况， 进一步完善磁共振血管成像 （magneticresonance angiography， MRA） 后比较两者的诊断结果。结果 70例患者中男51例， 女19例， 平均年龄 （66.4±11.9） 岁 ， CE-TCCD共检出41条交通动脉开放， 其中38条与MRA诊断一致， 超声造影与MRA诊断一致性好 （Kappa值为0.696， P ＜0.001） 。 超声造影检测的灵敏度为79.2%， 特异度为91.9%。结论 在颞骨声窗受限的脑梗死及TIA患者中 ， CE-TCCD可用于颅内侧支循环的评价。

Contrast-enhanced Transcranial Color-coded Doppler in Intracranial CollateralCirculation in Patients with Cerebral Infarction with Limited Bone Windows

Objective To observe the intracranial collateral circulation in patients with cerebral infarction andtransient ischemic attack with limited bone windows by using of contrast-enhanced transcranialcolor-coded Doppler (CE-TCCD).Methods Seventy patients with ischemic stroke, and transient ischemic attack of whom transcranialcolor-coded Doppler could not detect the intracranial blood flow because of limited bone windows,were detected the intracranial blood flow and the anterior and posterior communicating arteriesof Willis ring before magnetic resonance angiography(MRA) examination. And compared thediagnosis of both.Results Seventy patients consists of 51 males and 19 females, mean age was 66.4±11.9 years old.CE-TCCD were detected in 41 communicating arteries, 38 of which were consistent with the MRAdiagnosis. Diagnostic consistency between the two was good (Kappa value 0.696, P <0.001). Thesensitivity of CE-TCCD was 79.2% and the specificity of it was 91.9%.Conclusion Contrast-enhanced transcranial color-coded Doppler can be used to detect intracranialcollateral circulation in patients with cerebral infarction and transient ischemic attack with limitedbone windows.