脑中风患者彩色多普勒超声特征研究

目的 用彩色多普勒超声观察中老年人脑中风患者颅内及颈动脉形态、结构和血流动力学改变。方法 应用2．5MHz线阵探头分别观察155例不同类型脑中风患者和80例正常人颈动脉内中膜厚度、斑块情况及颅内与颈动脉血流动力学改变情况。结果 （1）各型脑中风组颈总动脉（CCA）内中膜厚度均较对照组明显增厚，斑块有109例出现（70．3％），而对照组仅4例（5．0％）出现斑块；（2）各型脑中风组颈内动脉时间平均流速（TAVICA）较正常组减低、阻力指数（RI）、搏动指数（PI）较正常组明显升高；（3）脑梗死组大脑中动脉时间平均流速（TAVMCA）较正常组低，脑出血组TAVMCA较正常组明显升高，混合性中风组可出现TAVMCA升高或降低两种情况。结论 中老年人各型脑中风患者颈动脉粥样硬化程度加重，斑块出现率高及斑块所引起的颈动脉狭窄，对脑中风有直接的因果关系，联合检查颅内动脉和颈动脉血流动力学改变可协助诊断不同类型脑中风，对其疗效观察，预防复发有一定的指导作用。

A Study of Color Doppler Flow Imaging of Intracranial Arteries and Carotid Arteries in Patients with Stroke

Objective To study the morphology,structure and hemodynamics of intracranial arteries and carotid arteries with color Doppler flow imaging in patients with stroke. Methods A noninvasive method based on color Doppler ultrasound was used for quantification of intima-media thickness,identification of plaque and determination of hemodynamics in intracranial arteries and carotid arteries.155 patients with stroke and 80 healthy subjects were imaged. Results (1) Intima-media thickness of common carotid arteries(CCA) in all type stroke patients were more thicker than that in healthy subjects.There were 109 patients with plaques in the bifurcation of the carotid artery.(2) Time average velocities of internal carotid artery(TAV ICA ) were significantly reduced in all type stroke patients than normal subjects.The resistance index(RI) and pulsatility index(PI) in stroke patient were higher than that in normal subjects.(3) Time average velocity of middle cerebral artery(TAV MCA ) was lower in cerebral infarction than normal subjects,TAV MCA was higher in cerebral hemorrhage than that in normal subjects,There were higher and lower TAV MCA in complex stroke. Conclusions The more severe atherosclerosis in all type stroke patients and high frequent appearance of plaques in carotid arteries were associated with the incidence of stroke.The study of color Doppler flow imaging of cerebral flow and carotid artery will help us predicting different type strokes,detecting the effects of treatment and reducing the recurrent stroke.