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目的 评价颈内动脉海绵窦瘘 (CCF)、脑动静脉畸形 (AVM )、烟雾病及脑动脉瘤的供血或病变动脉颅外段血管超声血流参数特点。方法 患者组 5 2例 ,其中CCF10例 ;AVM 13例 :主要供血动脉来源于椎基底动脉系统的AVM定为Ⅰ组 ,来源于颈内动脉系统的AVM定为Ⅱ组 ;脑动脉瘤 12例 ;烟雾病 17例 ;均经脑血管造影证实。正常对照组 5 5例健康志愿者。测量双侧颈总动脉 (CCA)、颈内动脉 (ICA)及椎动脉 (VA)的最大峰值流速 (Vmax)、舒张末血流速度 (Vmin)、平均血流速度 (Vmean)及阻力指数 (RI)。结果 与正常对照组相比 :①CCF患侧颈内动脉Vmin及Vmean升高 ,RI下降 (P <0 .0 5 ) ;②Ⅰ组位于小脑的 7例中 特大型AVM ,供血侧椎动脉的Vmax、Vmin、Vmean升高 ,RI降低 (P <0 .0 5 ) ;Ⅱ组位于顶、颞、额叶等部位的 6例中 大型AVM ,供血侧颈内动脉血流参数无明显变化 (P >0 .0 5 ) ;③脑动脉瘤载瘤侧颈内动脉血流参数无明显变化 (P >0 .0 5 ) ;④烟雾病患侧颈总动脉及颈内动脉Vmean降低 ,RI升高 (P <0 .0 5 )。结论 CCF、烟雾病及位于小脑中型以上的AVM的供血或病变动脉颅外段血管超声血流参数的变化具有特征性 ,可为临床诊断脑血管病提供参考。
Objective To evaluate the characteristics of arterial blood flow (ICF), cerebral arteriovenous malformation (AVM), moyamoya disease and cerebral aneurysm in the extracranial arteries. Methods Fifty-two cases of patients with CCF were involved, including 10 cases of CCF and 13 cases of AVM. The AVMs of vertebrobasilar system from the main feeding arteries were classified as group Ⅰ, the AVMs from internal carotid arteries were classified as group Ⅱ, 12 cases of cerebral aneurysms, Smoke disease in 17 cases were confirmed by cerebral angiography. The normal control group of 55 healthy volunteers. The maximum peak velocity, Vmin, Vmean and resistance index of bilateral common carotid artery (CCA), internal carotid artery (ICA) and vertebral artery (VA) RI). Results Compared with the normal control group, the VMC and Vmean of the internal carotid artery increased and the RI decreased (P <0.05) in the ipsilateral CCF. ② In the Ⅰ group, 7 cases of extralarge AVM in the cerebellum, Vmax of the blood supply side vertebral artery, Vmin and Vmean increased, while RI decreased (P <0.05). There were 6 cases of medium-sized AVM in group Ⅱ at the top, the temporal and the frontal lobe, and there was no significant change in the parameters of blood flow in the internal carotid artery (P> 0.05) .③The Vmean of the common carotid artery and internal carotid artery decreased and the RI increased (P <0 .0 5). Conclusions CCF, moyamoya disease and AVM located above the cerebellum are characterized by changes in blood flow parameters of the extracranial arterial blood vessels, which may provide a reference for the clinical diagnosis of cerebrovascular disease.