超声造影联合经颅多普勒评估后循环缺血的颈动脉病变
Evaluation of internal carotid artery lesions in combination with carotid contrast-enhanced ultrasound and transcranial Doppler in patients with posterior circulation ischemia
陈艳 1郑峥 1李建卫 1林宁 1吴长明1
作者信息
- 1. 350001 福州，福建医科大学省立临床医学院/福建省立医院
- 折叠
摘要
目的：探讨颈动脉超声造影(contrast-enhanced ultrasound，CEUS)联合经颅多普勒(transcranial Doppler，TCD)评估后循环缺血(posterior circulation ischemia，PCI)患者颈动脉病变的价值。方法将125例PCI患者分为脑梗死组52例、短暂性脑缺血发作(TIA)组73例，同时行颈动脉CEUS和TCD检测。同期设立健康对照组54例。比较脑梗死组和TIA组颈内动脉颅外段斑块的稳定性、狭窄程度，评估颈动脉狭窄对后循环血流动力学的影响。结果①脑梗死组颈内动脉颅外段所检出的斑块中，易损斑块占66.3%(61/92)，高于TIA组39.7%(29/73)，差异有统计学意义(P <0.01)。②脑梗死组易损斑块的发生率为65.4%(34/52)，高于TIA组的42.5%(31/73)，差异有统计学意义(P <0.05)。③脑梗死组颈内动脉颅外段≥50%狭窄的发生率为32.7%(17/52)，高于TIA组16.4%(12/73)，差异有统计学意义(P <0.05)。④发现前循环盗血的PCI患者11例，其大脑后动脉P1段、基底动脉、双侧椎动脉颅内段峰值流速显著高于对照组(P <0.05)。结论联合颈动脉CEUS和TCD检测有助于发现PCI患者合并的颈内动脉粥样硬化病变，识别易损斑块，评估前后循环的血流动力学变化。
Abstract
Objective To evaluate internal carotid artery lesions in patients with posterior circulation ischemia(PCI) with carotid contrast-enhanced ultrasound(CEUS) and transcranial Doppler(TCD). Method A total of 125 patients with PCI were divided into an infarction group(n=52) and a transient ischemia attack(TIA) group(n=73). They were all underwent carotid CEUS and TCD examination. Fifty-four healthy subjects were selected as control group. The plaque characteristics and stenosis of extracranial internal carotid artery of the infarction group and TIA group were compared. The stenosis of extracranial internal carotid artery and its effect on hemodynamics of posterior circulation artery were evaluated. Results ①Among the plaque detected from extracranial internal carotid artery, the vulnerable plaque was 66.3%(61/92) in cerebral infarction group. It was significantly higher than 39.7%(29/73) in the TIA group. There was statistical significance(P <0.01). ②The occurrence of vulnerable plaque was 65.4%(34/52) in the infarction group. It was significantly higher than 42.5%(31/73) in the TIA group. There was statistical significance (P <0.05).③The incidence of ≥50% stenosis of extracranial internal carotid artery in the infarction group was 32.7%(17/52). It was higher than 16.4%(12/73) in the TIA group. There was statistical significance(P <0.05). ④The peak velocity of posterior cerebral artery P1 segment, basilar artery and intracranial vertebral artery were significantly higher than that in control group(P <0.05) in 11 anterior circulation steal patients. Conclusion CEUS combined with TCD can help to evaluate internal carotid artery atherosclerostic lesions, identify the vulnerable plaque, appraise hemodynamics of anterior and posterior circulation artery in patients with PCI.
关键词
超声检查/多普勒/经颅/介入性/椎基底动脉供血不足/对比剂/侧支循环Key words
Ultrasonography/Doppler/Transcranial/Interventional/Vertebrobasilar insufficiency/Contrast media/Hemodynamics/Collateral circulation引用本文复制引用
基金项目
2012年福建省卫生厅面向农村和城市社区推广适宜技术项目计划(2012008)
出版年
2013
NETL
NSTL
维普
万方数据