老年后循环血流异常的多普勒超声评估

目的探讨多普勒超声评估后循环血流异常的类型、病变部位及产生原因。方法对375例经磁共振血管成像和(或)数字减影血管造影证实的颅内外动脉严重狭窄或闭塞的老年患者,采用经颅多普勒超声(TCD)和颈动脉连续波多普勒超声(CWD)评估后循环血流异常。结果375例患者共检测1875支后循环动脉,其中776支动脉血流异常:分别为狭窄血流(73支)、无血流(44支)、低流速低搏动(48支)、低流速高搏动(38支)、代偿血流(472支)和窃血频谱(101支)。狭窄血流和无血流均在病变部位直接检出,其他4种类型血流异常则是出现在病变部位近端或远端动脉的间接血流改变。结论采用TCD和CWD评估后循环血流异常,可为临床寻找后循环缺血的原因和更深入研究缺血性脑血管病的发病机制提供重要的客观依据。

Abnormal blood flow of posterior circulation in aged patients assessed by Doppler ultrasonography

Objective To explore the pattern,lesion location and cause of abnormal blood flow of posterior circulation assessed by Doppler ultrasonography.Methods In 375 aged patients with severe stenosis or occlusion of intracranial or extracranial artery determined by MR angiography and/or digital subtraction angiography,the abnormal blood flow of posterior circulation was evaluated with transcranial Doppler(TCD) and cervical continuous-wave Doppler(CWD).Results In 375 patients,1 875 posterior circulation arteries were evaluated.Seven hundred and seventy-six arteries showed abnormal flow that manifested stenosis flow(73 arteries),absent flow(44 arteries),low velocity and pulsation(48 arteries),low velocity and high pulsation(38 arteries),compensatory flow(472 arteries) and steal spectrum(101 arteries).The stenosis flow or absent flow was discovered directly in lesion site.However,other 4 patterns of abnormal blood flow resulted from indirect flow changes of arteries proximal or distal to the lesion site.Conclusions Evaluation of the abnormal blood flow of posterior circulation with TCD and CWD might provide important and objective basis for discovering the cause of posterior circulation ischemia and for exploring deeply the pathogenesis of ischemic cerebrovascular disease.