经颅多普勒超声评估分水岭梗死患者的Willis环侧支循环能力

目的探讨分水岭梗死患者的Willis环侧支循环能力。方法对100例一侧颈内动脉闭塞患者,采用经颅多普勒超声检测Willis环的侧支循环通路。结果48例分水岭梗死患者,27%未发现Willis环侧支循环通路,13%出现后交通动脉侧支血流。52例无分水岭梗死患者,4%未发现Willis环侧支循环通路,后交通动脉侧支开放的比率增高至52%(P<0.01)。前交通动脉侧支开放的比率两组大致相同,分别为60%和63%。结论一侧颈内动脉闭塞患者,无Willis环侧支循环和低比率的后交通动脉侧支开放与发生分水岭梗死相关。

COLLATERAL ABILITY OF THE CIRCLE OF WILLIS ASSESSED WITH TRANSCRANIAL DOPPLER IN PATIENTS WATERSHED INFARCTS

Objective To assess the collateral ability of the circle of Willis in patients with watershed infarcts.Methods In 100 patients with unilateral internal carotid artery occlusion,collateral circulation pathway in the circle of Willis was measured with transcranial Doppler.Results In patients with watershed infarcts(n=48),collateral circulation pathway in the circle of Willis was not found in 27%,and collateral flow in the posterior communicating artery was found in 13%.In patients without watershed infarcts(n=52),collateral circulation pathway in the circle of Willis not was found in 4%,and the percentage of collateral flow via the posterior communicating artery greatly increased to 52%(P<0.01).The percentage of collateral flow via the anterior communicating artery was in the same range for patients with/without watershed infarcts(63% and 67%,respectively).Conclusions In patients with unilateral internal carotid artery occlusion,no collateral circulation pathway in the circle of Willis and a low percentage of collateral flow via the posterior communicating artery is associated with watershed infarcts.