应用经颅多普勒超声经眼窗对大脑前动脉和大脑中动脉血流的探测

目的探讨TCD经眼窗探测ACA和MCA血流的可行性。方法对50名双侧颞窗、眼窗均透声良好的健康体检者，采用TCD经眼窗探测双侧大脑半球血流改变，并与经颞窗（对照组）探测的大脑半球血流改变进行比较，同时对612例共67个透声不良颞窗，经眼窗探测的双侧ACA和MCA血流速度结果进行分析。结果经眼窗探测50名健康者ACA血流速度，与对照组比较差异无统计学意义（P〉0．05）；经眼窗探测的MCA血流速度显著低于对照组（P〈0．01），但仍有48支（48％）MCA与经颞窗探测的血流速度差值〈10％。67个透声不良颞窗中，女性发生率（8％）显著高于男性（3％），P〈0．01。经眼窗检出ACA48支（72％），MCA38支（57％），男、女性别差异无统计学意义（P〉0．05），ACA的检出率高于MCA。结论经眼窗探测ACA结果可靠，探测MCA具有参考价值。当颞窗透声不良时，经眼窗检测可提高TCD的检出率。

Detection of anterior and middle cerebral arterial hemodynamics through the transorbital window with TCD

Objective To evaluate the feasibility of the blood flow of anterior cerebral artery (ACA) and middle cerebral artery (MCA) through the transorbital window with transcranial Doppler (TCD). Methods Fifty healthy persons whose cerebral blood flow in bilateral hemispheres were detected through their transorbital windows with TCD, and compared with the findings detected through their transtemporal windows (control group). At the same time, in 67 with poor insonated through their transtemporal window, the results of blood velocity in the bilateral ACA and MCA detected through their transorbital window were analyzed. Results There was no significant difference between the healthy subjects and the control group in the blood velocity of ACA detected through the transorbital windows (P>0.05); the flow velocity of MCA detected through the transorbital windows was significantly lower than that of the control group (P<0.01). However, there were still 48 MCAs (48%) that were less than 10% as compared with the value of the flow velocity detected through the transtemporal windows. In 67 patients who were poorly insonated through their transtemporal windows, the proportion of females (8%) was significantly higher than that of males (3%) (P<0.01); 48 (72%) ACAs and 38 (57%) MCAs were detected through their transorbital windows, and there were no significant differences between the males and females(P>0.05). The detection rate of ACA was higher than that of MCA. Conclusion The results of ACA detected through the transorbital window are reliable, and the detection of MCA has some reference values only. It may improve the detection rate of TCD through the transorbital window if poorly insonated through the transtemporal window.