经颅多普勒对分水岭脑梗死的检查评价

目的探讨经颅多普勒对分水岭脑梗死的临床使用价值。方法所有病例均行头MRI、TCD以及主动脉弓、全脑血管造影（DSA）检查，并证实为分水岭脑梗死。结果一侧颈内动脉系统狭窄或闭塞的10例患者中TCD示6例患侧ACA1血流方向逆转，4例患侧OA血流方向逆转，7例健侧ACA，血流速度高于患侧，6例患侧PCA血流速度增快；14例大脑中动脉主干或上干狭窄或闭塞的患者中TCD示6例大脑中动脉阶段性高流速，6例大脑中动脉未探及血流，2例大脑中动脉低流速伴高PI；1例一侧颈内动脉系统轻度狭窄的患者TCD无明显的变化。结论经颅多普勒能够有效地评价分水岭脑梗死患者脑血管狭窄和侧枝循环的代偿情况。

The significance of transcranial doppler in evaluating watershed infarction

Objective To study the significance of TCD in evaluating cerebral watershed infarction （CWI）. Methods 25 cases of CWI had examinations of head magnetic resonance imaging （MRI）, transcranial doppler （TCD） and digital subtraction angiography （DSA）. Results In 10 patients with stenosis or occlusion of unilateral internal carotid artery （ICA） with DSA, the reversion of blood flow in ACA1 were seen in affected ICA, in 6 cases TCD showed that the blood flow reversed in 4 cases in ophthalmic arteries, the blood flow rate of ACA1 in uninjured side were higher than those in affected ACA1 in 7 cases, and the blood flow rate of PCA1 in affected side was higher than that in uninjured side in 6 cases. In 14 patients with highly stenosis or occlusion of the main trunk or superior trunk of unilateral middlel cerebral artery （MCA）, the focal high blood flow was seen in 6 cases, there was no blood flows in 6 cases and there was low blood flows in 2 cases accompanied by high PI. There was not marked change of blood flow in one patient with slight stenosis of unilateral ICA with DSA. Conclusions TCD can correctly evaluate cerebral artery stenosis, collateral pathways in patients with watershed infarction.