超声与磁共振血管成像在急性颈内动脉闭塞中的应用

孟 璇; 王 欣; 李兴杰; 童明辉; 周俊林

中国临床医学影像杂志 ›› 2010, Vol. 21 ›› Issue (3) : 168-170.

论著

超声与磁共振血管成像在急性颈内动脉闭塞中的应用

孟璇，王欣，李兴杰，童明辉，周俊林

作者信息 +

Synergetic application of ultrasonography and MRA in acute internal carotid artery occlusion

MENG Xuan, WANG Xin, LI Xing-jie, TONG Ming-hui, ZHOU Jun-lin

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摘要

目的：探讨超声、磁共振血管成像（MRA）对急性颈内动脉闭塞的诊断价值。方法：采用彩色多普勒（CDFI）、经颅多普勒（TCD）结合MRA筛查急性单侧颈内动脉闭塞56例患者，用TCD、MRA评价颅内动脉的脑血流动力学变化并与DSA进行比较。结果：颈内动脉闭塞发生在颅外段46例，颅内段10例。后交通动脉显示率MRA高于TCD（P＜0.05）；眼动脉参与的侧支循环显示率TCD高于MRA（P＜0.01）；TCD联合MRA显示侧支动脉与DSA之间无显著性差异。患侧大脑中动脉峰值流速和搏动指数均明显低于健侧（P＜0.001）。结论：超声与MRA能够很好显示急性ICA闭塞后颅内血流动力学变化和侧支循环状态。超声检查方便快捷，可作为首选方法。超声联合MRA可替代或减少有创的DSA。

Abstract

Objective: To evaluate the diagnostic value of ultrasonography and magnetic resonance angiography(MRA) on acute internal carotid artery(ICA) occlusion. Methods: Color Doppler flow imaging(CDFI), transcranial Doppler(TCD) and MRA were used to screen 56 patients with unilateral acute ICA occlusion, and then to evaluate intracerebral artery hemodynamic changes of selected patients by TCD and MRA, the results were compared with digital subtractive angiography(DSA). Results: Forty-six cases of ICA occlusion located at extracranial proximal segment of ICA, 10 cases at intracranial segment of ICA. The demonstration rate of the posterior communicating artery(PCoA) on MRA was significantly higher than that on TCD(P<0.05). The opening rate of ophthalmic artery(OA) on TCD was significantly higher than that on MRA(P<0.05). There was no significant difference between synergetic using ultrasonography combined MRA and DSA in demonstrating collateral circulation. The peak velocity(Vp) and PI of middle cerebral artery(MCA) in the stenostic side were significantly lower than those on the healthy side(P<0.001). Conclusion: Ultrasonography and MRA could detect the hemodynamic changes and the collateral circulation in acute ICA occlusion. Ultrasonography diagnose lesions conveniently and quickly, which should the first choice of examination. Synergetic using ultrasonography and MRA may substitute or reduce the application of invasive DSA.

导出引用

孟璇;王欣;李兴杰;童明辉;周俊林. 超声与磁共振血管成像在急性颈内动脉闭塞中的应用[J]. 中国临床医学影像杂志. 2010, 21(3): 168-170

MENG Xuan;WANG Xin;LI Xing-jie;TONG Ming-hui;ZHOU Jun-lin. Synergetic application of ultrasonography and MRA in acute internal carotid artery occlusion[J]. Journal of China Clinic Medical Imaging. 2010, 21(3): 168-170

中图分类号： Ｒ543.5 Ｒ445.2 R445.1