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目的通过应用经颅多普勒(TCD)检测蛛网膜下腔出血患者的颅内血流状况,诊断脑血管痉挛(CVS)并经过数字减影血管造影(SDC)证实,说明TCD诊断CVS的可靠性。方法应用TCD检测2000-2005年CT已经明确诊断为蛛网膜下腔出血Ⅰ～Ⅲ级患者49例(Ⅳ～Ⅴ级患者病情严重不宜做血管造影检查,因此不做讨论)。于患病后第1天开始,每隔3d监测一次,动态观察10d。观察血管参数:大脑中动脉(MCA)、颈内动脉终末段(TICA)、颈内动脉颅外段(ICA)的收缩期峰值流速(Vs)、平均血流速度(Vm)以及大脑中动脉与颈内动脉颅外段(ICA)峰值流速的比值(∨MCA/∨ICA),同时行SDC检查证实。结果49例患者中,TCD提示CVS者26例,痉挛条数33条。数字减影血管造影结果显示CVS者31例,痉挛条数36条,TCD诊断CVS的敏感率为83.8%,TCD诊断CVS特异性为91.6%。结论TCD技术与SDC相比具有操作简便、价廉、实时无创、敏感有效,容易重复检查等优点。
Objective To detect the intracranial blood flow in patients with subarachnoid hemorrhage by transcranial Doppler (TCD), to diagnose cerebral vasospasm (CVS) and to confirm by digital subtraction angiography (SDC), to demonstrate the reliability of TCD in the diagnosis of CVS Sex. Methods TCD was used to detect 49 cases of grade Ⅰ ~ Ⅲ patients diagnosed as subarachnoid hemorrhage from 2000 to 2005 (Ⅳ ~ Ⅴ grade patients with serious illness should not be angiography, so do not discuss). On the first day after the illness began, once every three days, the dynamic observation of 10d. The vascular parameters were measured: the middle cerebral artery (MCA), the internal carotid artery terminal segment (TICA), the peak systolic velocity (Vs) and mean arterial blood flow velocity (Vm) And ICA peak flow velocity ratio (∨MCA / ∨ICA), simultaneous SDC confirmed. Results Among the 49 patients, TCD indicated that 26 cases had CVS and 33 spasticity. Digital subtraction angiography showed that 31 cases had CVS and 36 spasticity. The sensitivity of TCD in diagnosing CVS was 83.8% and that of TCD in diagnosing CVS was 91.6%. Conclusion TCD technology compared with the SDC has the advantages of simple, inexpensive, real-time non-invasive, sensitive and effective, easy to repeat the check and so on.