经颅彩色多普勒血流显像对出血性脑血管病的诊断价值

目的探讨经颅彩色多普勒超声血流显像技术（CDFI）对出血性脑血管病及脑血管痉挛诊断的价值。方法回顾性分析266例出血性脑血管病患者的CDFI诊断结果，并与数字减影脑血管造影（DSA）结果进行对照分析。结果以DSA为金标准，CDFI检出率颅内动脉瘤为84．5％（82／97）、脑动静脉畸形为91．7％（88／96）、烟雾病为96．8％（61／63）、脑血管痉挛86．2％（75／87），CDFI假阴性25例：结论彩色多普勒超声能实时、动态、无创地观察颅底血管及血流动力学变化，对筛选诊断颅内动脉瘤、脑动静脉畸形、烟雾病等出血性脑血管病以及观察蛛网膜下腔出血后脑血管痉挛的发生发展过程具有重要的临床指导意义。

Value of Transcranial Color Doppler Flow Imaging to Diagnosis of Hemorrhagic. Cerebrovascular Disease

Objective To investigate the diagnostic values of transcranial color Doppler flow imaging （CDFI） to the hemorrhagic cerebrovascular disease and cerebral vasospasm. Methods The CDFI examination outcomes of 266 patients with hemorrhagic cerebrovascular disease were analysed retrospectively, and compared with the digital subtraction angiography （DSA） examination ones. Results According to DSA examination, there were positive outcomes in 256 patients, and negative in 10. According to CDFI examination, there were positive outcomes in 231 patients, and negative in 35. DSA served as the gold standard. CDFI detection rates were 84.5% in intracranial aneurysms, 91.7% in cerebral arteriovenous malformations, 96.8% in Moyamoya disease, and 86.2% in cerebral vasospasm. Conclusions The non-invasive, real-time and dynamic observation of the skull base vessels and changes in their blood flow dynamics can be made by color Doppler uhrasound. CDFI is of important clinical value to diagnosis of hemorrhagic cerebrovascular disease, including intracranial aneurysms, cerebral arteriovenous malformations, Moyamoya disease and so on, and to observation of the development process of cerebral vasospasm after subarachnoid hemorrhage.