经颅超声多普勒检查方法学的再探讨

目的：重新探讨经颅多普勒检查(transcranial Doppler，TCD)方法。方法：利用经颅多普勒血流显像(transcranial Doppler flow image，TCDFI)和脉冲波多普勒(pulse wave Doppler，PW)检查1910例门诊及住院患者Willis环及其主要分支，测量血流参数，部分患者利用多普勒能量图(Doppler power image，DPI)和三维多普勒能量图(tri-dimensional Doppler power image，3DDPI)显示Willis环及其分支的空间结构。结果：经枕窗和颞窗检查，能够显示Willis环及其分支血流的共1739例，显示血管内血流后几乎均能显示满意的血流频谱；109例不能完整显示Willis环及其分支或椎动脉、基底动脉，39例通过枕窗不能显示椎动脉和基底动脉，23例通过颞窗不能显示同侧的大脑前、中、后动脉。结论；绝大多数患者(91．05％)可以经TCDFI检查满意地显示颅内Willis环及其分支和椎动脉、基底动脉，并且在TCDFI引导下可以校正颅内主要动脉与声束的夹角，更准确地测量血流参数、评价颅内动脉的血流动力学变化，并有可能显示颅内的解剖结构异常。

Re-study on Methodology of Transcranial Doppler

Objective:To restudy the method of transcranial Doppler (TCD).Methods:The exa-minations of transcranial Doppler flow image (TCDFI) and pulse wave Doppler (PW) were completed in 1910 outpatients and inpatients in order to display Circle of Willis and its branches,of which the structures were shown in some of the patients by Doppler power image (DPI) and tri-dimensional Doppler power image (3DDPI).Results:Passing through temporal bone and foramen magnum,Circle of Willis and its branches,vertebral artery (VA) and basilar artery (BA) were shown completely in 1739 cases with satisfied blood stream spectra;partly in 23 cases through temporal bone and in 39 cases through foramen magnum.Conclusions:With TCDFI,Circle of Willis and its branches,vertebral artery,basilar artery can be displayed in most of the patients (91.05%).Accurate blood stream parameters and evaluation of transcranial hemodynamics can be obtained under the instruction of TCDFI.It is also possible to demonstrate the anomalies of intracranial constitution by TCDFI.