颅内动脉狭窄的经颅多普勒与数字减影血管造影比较

目的通过比较经颅多普勒（TCD）与数字减影血管造影（DSA）在颅内动脉狭窄中的诊断价值，为临床提供简便可靠的检查方法。方法对50例疑有颅内动脉狭窄的患者应用TCD测量各条血管的血流参数，包括收缩峰值流速、舒张末流速、平均流速、阻力指数，并与DSA结果进行对比分析。结果38例TCD诊断颅内动脉狭窄，35例经DSA证实。TCD诊断颅内动脉狭窄的特征是狭窄处彩色血流束变细，典型者呈“束腰征”；频谱多普勒显示狭窄处血流速度异常增高，频谱形态呈湍流、涡流，同时音频信号响亮。狭窄严重者彩色血流束连续性欠佳或者中断，血流速度不增快或者明显减低。血管闭塞者血流不显示。结论TCD对于颅内动脉狭窄具有一定的诊断价值，TCD检查快速、方便、安全、经济、确诊率高，可作为早期筛选性的诊断方法。

Comparison between transcranial doppler and digital subtraction angiography in intracranial artery stenosis

Objective To provide a convenient and reliable examination method for clinical practice by comparing the diagnostic values between transcranial Doppler （TCD） and digital subtraction angiography （DSA） in Intracranial artery stenosis. Methods Fifty patients who had been highly suspected cerebral arterial stenosis were detected by TCD. Hemodynamic parameters such as systole peak velocity, diastole end velocity, mean velocity and resistance index were measured. All results were compared with digital subtraction angiography（ DSA）. Results Tirty - eight patients were diagnosed intracranial artery stenosis by TCD. Thirty - five cases were considered by DSA. According to TCD, the characteristic imaging of intracranial artery stenosis was that the blood flow beam became narrow and looked like girdling. The velocity of the loci increased abnormally. The frequency spectrum of the stenotic vascular showed turbulence, meanwhile noise accompanied. The severe stenosis showed uncontinuity of the blood flow beam. The velocity of the loci was not increased or decreased obviously. The blood flow beam of the occlusive artery can not been seen. Conclusions TCD is valuable in diagnosing intracranial artery stenosis. The TCD examination has the quick, convenient, safe, and cheap advantages with a higher rate of final diagnosis. The TCD examination can be considered as a diagnostic method of early screening.