经颅多普勒超声与CTA在缺血性脑血管病诊断中的应用

目的探讨256层螺旋CT血管造影(CTA)和经颅多普勒超声(TCD)对缺血性脑血管病患者颅内动脉狭窄诊断上的应用价值,分析颅内动脉狭窄的危险因素。方法选取于我院神经内科收治的缺血性脑血管病患者132例,其中狭窄组85例,正常组47例,均行CTA和TCD检查,分析TCD和CTA对缺血性脑血管病颅内动脉狭窄诊断的一致性,并分析血管狭窄形成的危险因素。结果(1)TCD与CTA对于颅内动脉血管狭窄检查存在良好的一致性(Kappa>0.5),特别是对于重度狭窄患者的诊断一致性最高(Kappa=0.838)。(2)血中低密度脂蛋白水平、糖尿病史、吸烟史为影响颅内血管狭窄的危险因素。结论 TCD对缺血性脑血管病患者颅内动脉狭窄的诊断与CTA有很好的一致性,为临床筛查颅内动脉狭窄提供可靠的影像学依据。

The Application of Transcranial Doppler Ultrasound and CTA in the Diagnosis of Ischemic Cerebrovascular Disease

Objective To investigate the value of 256-slice spiral CT angiography(CTA)and transcranial Doppler ultrasound(TCD)in the diagnosis of intracranial artery stenosis in patients with ischemic cerebrovascular disease,and to analyze the risk factors of intracranial artery stenosis.Methods From 132 patients with ischemic cerebrovascular disease were selected from Department of Neurology,Affiliated Hospital of North China University of Technology.There were 85 cases in stenosis group and 47 cases in normal group.All patients underwent CTA and TCD examinations.Analysis of TCD and CTA in the diagnosis of intracranial arterial stenosis in ischemic cerebrovascular disease and analyze the risk factors of angiostenosis.Results(1)TCD and CTA had good consistency in the examination of intracranial artery stenosis(Kappa>0.5),especially in the diagnosis of severe stenosis(Kappa=0.838).(2)Blood LDL level,history of diabetes mellitus and smoking were risk factors for intracranial vascular stenosis.Conclusions TCD has a good consistency with CTA in the diagnosis of intracranial artery stenosis in patients with ischemic cerebrovascular disease,which provides reliable imaging basis for clinical screening of intracranial artery stenosis.