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目的 了解经颅多普勒超声仪（TCD）及磁共振血管造影（MRA）在缺血性脑血管病人中探查脑血管狭窄性病变的可能性及相关性,探讨MRA对缺血性脑血管病的临床应用。方法 对53例住院患者行TCD、MRA及磁共振成像检查,分别分析双侧大脑中动脉、大脑前动脉、大脑后动脉、椎动脉、基底动脉的TCD、MRA的结果及两者的相符性。同时通过TCD对以上各血管狭窄性病变检出的灵敏度、特异度、阳性预期值、阴性预期值来综合分析TCD的临床应用价值。结果53例中MRA显示有脑血管病变的患者,TCD也有相应的相符率。TCD显示异常的血管,MRA也有相应变化的相符率。TCD异常的表现,主要为血流速度增快,其中又可分两侧对称型及不对称型。在不对称型患者中,TCD与MRA结果的相符率明显增加,在MCA及ACA中分别可达到85.7％和57.1％,均分别高于总的相符率78.9％及33.3％,且一侧Vm低于正常范围低限,对侧同名动脉Vm高于正常范围高限时,TCD与MRA结果的相符率最高达到100％。结论TCD对脑血管狭窄性病变检出的敏感性较低,特别是对后循环血管狭窄病变检出的假阴性率较高。但对两侧不对称型的高血流血管,TCD对病变血管检出的特异度较高,且与MRA的相符率也较高。
Objective To investigate the possibility and correlation of transcranial Doppler ultrasound (TCD) and magnetic resonance angiography (MRA) in detecting cerebral vascular stenosis in patients with ischemic cerebrovascular disease, and to explore the effect of MRA on ischemic cerebrovascular disease Clinical application. Methods TCD, MRA and MRI were performed in 53 inpatients. The results of TCD and MRA in bilateral middle cerebral artery, anterior cerebral artery, posterior cerebral artery, posterior cerebral artery, vertebral artery and basilar artery were analyzed respectively. At the same time, TCD was used to comprehensively analyze the clinical value of TCD using the sensitivity, specificity, positive predictive value and negative predictive value of TCD. Results 53 cases of MRA showed cerebrovascular disease in patients, TCD also have the corresponding rate. TCD showed abnormal blood vessels, MRA also have a corresponding change in the rate of compliance. TCD abnormal performance, mainly for faster blood flow, which can be divided into two sides symmetrical and asymmetric type. In unsymmetrical patients, the coincidence rates of TCD and MRA were significantly increased, reaching 85.7% and 57.1% in MCA and ACA, respectively, which were higher than the overall compliance rate of 78.9% and 33.3%, respectively, and the Vm low In the lower limit of normal range, the conformed rate of TCD and MRA was up to 100% when Vm of contralateral same name artery was higher than the upper limit of normal range. Conclusions TCD is less sensitive to the detection of cerebrovascular stenosis, especially for the detection of posterior circulation vascular stenosis. However, on both sides of the asymmetric type of high blood vessels, TCD detection of vascular lesions higher specificity, and consistent with MRA also higher.