椎动脉超声表现与后循环缺血的相关性分析-东南大学学报医学版

椎动脉超声表现与后循环缺血的相关性分析

单位：1. 东南大学附属中大医院超声科, 江苏南京 210009;
2. 常州市第七人民医院超声科, 江苏常州 213011

分类号：R445.1;R543.5

出版年·卷·期（页码）：2015·34·第四期（613-616）

摘要：

目的:探讨应用彩色多普勒血流显像(CDFI)检测颅外段椎动脉评估后循环缺血(PCI)的可行性。方法:临床拟诊为脑部疾病的住院患者,应用多普勒超声检测、记录颅外段椎动脉的管腔内径(D)、收缩期峰值流速(Vs)、舒张末期流速(Vd)、血流阻力指数(RI)。所有病例根据超声检查结果分为椎动脉CDFI表现正常组和异常组;根据同期颅脑MRI检查和临床表现,分为PCI组和非PCI组。分别对椎动脉D和血流动力学的CDFI测值与PCI进行相关性分析。结果:91例患者(年龄28~87岁)中,PCI63例,非PCI28例。在PCI组中,椎动脉CDFI显示异常54例,正常9例;在非PCI组中,椎动脉CDFI显示异常7例,正常21例。椎动脉CDFI表现异常和正常两组的PCI发生率分别为88.5%和30%,椎动脉CDFI表现异常组的PCI发生率明显高于正常组。根据椎动脉CDFI表现评估PCI的灵敏度为85.71%,特异度为75.00%。D与PCI的相关系数为-0.37(P<0.01),Vs与PCI的相关系数为-0.31(P<0.01),Vd与PCI的相关系数为-0.50(P<0.01),RI与PCI的相关系数为0.56(P<0.01),差异均有统计学意义。结论:椎动脉CDFI测值中,D、Vs、Vd与PCI发生呈负相关,RI与PCI的发生呈正相关。椎动脉CDFI检测有可能为评估PCI提供重要的诊断依据。

Objective: To explore the effect of color Doppler flow imaging(CDFI) in evaluating the feasibility of posterior circulation ischemia(PCI) by detecting extracranial vertebral arteries. Methods: The inpatients suspected with brain diseases clinicly underwent Doppler ultrasound examination, the inner diameters of extracranial vertebral arteries and it's blood floor-maximal systolic velocity(Vs), minimal diastolic velocity(Vd), resistant index(RI) were measured. According to the ultrasonic results, all cases were divided into normal and abnormal group. At the same time, all the patients were divided into PCI and non PCI group by examination of brain MRI and clinic symptoms. The correlation of CDFI normal and abnormal manifestations with PCI was analized respectively. Results: In 91 patients(age 28-87), 63cases were PCI and 28 with non PCI. In the PCI group,54 cases were abnormal by detection of CDFI,9 cases were normal.In the non PCI group,7 cases were abnormal by detection of CDFI,21 cases were normal. The PCI incidence in the abnormal group was higher than that in the normal group. The CDFI sensitivity was 85.71%, specificity was 75.00%. The correlation coefficients were as follows, D and PCI of -0.37(P<0.01), Vs and PCI of -0.31(P<0.01), Vd and PCI of -0.50(P<0.01), RI and PCI of 0.56(P<0.01), all indexes had statistical significances. Conclusion: In the data of vertebral arteries detected by CDFI, D, Vs, Vd have nagtive correlation with PCI, RI has positive correlation with PCI. The examination of CDFI can provide an important basis for evaluation of PCI.

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