柳曦,王金锐.颅外颈动脉血流动力学变化与缺血性脑血管病的关系[J].中国医学影像技术,2012,28(9):1646~1649
颅外颈动脉血流动力学变化与缺血性脑血管病的关系
Relationship between hemodynamic changes of extracranial carotid artery and ischemic cerebrovascular diseases
投稿时间:2012-04-06  修订日期:2012-05-19
DOI:
中文关键词:  颈动脉  超声检查  脑缺血  血流动力学
英文关键词:Carotid arteries  Ultrasonography  Brain ischemia  Hemodynamics
基金项目:
作者单位E-mail
柳曦 北京大学第三医院超声诊断科, 北京 100191  
王金锐 北京大学第三医院超声诊断科, 北京 100191 jingrui_wang@sina.com 
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中文摘要:
      目的 探讨颅外颈动脉血流动力学改变与颅内缺血性脑血管病的关系。方法 对52例缺血性脑血管患者(患者组)及30名健康志愿者(对照组)行颅外颈动脉超声检查,检查部位包括颈总动脉(CCA)、颈内动脉(ICA)及椎动脉(VA),分析血流动力学指标及多普勒波形的特点。结果 ①与对照组相比,患者组双侧颈总动脉收缩峰值流速差(ΔCCA-PSV)、双侧颈总动脉阻力指数差(ΔCCA-RI)、双侧颈内动脉收缩峰值流速差(ΔICA-PSV)、双侧颈内动脉舒张末期流速差(ΔICA-EDV)、双侧颈内动脉阻力指数差(ΔICA-RI)及双侧椎动脉阻力指数差(ΔVA-RI)均明显增高(P均<0.05),而双侧ICA及VA收缩期S1与S2段波峰斜率比值的绝对值(LICA-SL1/SL2、RICA-SL1/SL2、LVA-SL1/SL2、RVA-SL1/SL2)均明显减低(P均<0.05);②ROC曲线分析结果显示,ΔICA-PSV、ΔICA-EDV、ΔVA-RI、右侧ICA-SL1/SL2诊断缺血性脑血管病的ROC曲线下面积(AUC)均在0.7以上;③患者组与对照组间ICA及VA多普勒波形的对称性差异有统计学意义(P均<0.05)。结论 颅内缺血性脑血管病可致颅外颈动脉血流动力学改变;利用颅外颈动脉多普勒可预测颅内缺血性脑血管病。
英文摘要:
      Objective To explore the relationship between hemodynamic changes of extracranial carotid arteries and ischemic cerebrovascular diseases. Methods Totally 52 patients with ischemic cerebrovascular diseases (patient group) and 30 healthy volunteers (control group) underwent carotid artery duplex ultrasonography with the detecting positions as common carotid artery (CCA), internal carotid artety (ICA) and vertical artery (VA). The hemodynamic parameters of carotid arteries and the features of Doppler waveform were analyzed. Results ①Compared with control group, the differences of hemodynamic parameters between bilateral vascular included peak systolic velocity (PSV) and resistance index (RI) of CCA (ΔCCA-PSV and ΔCCA-RI), PSV, end diastolic velocity (EDV) and RI of ICA (ΔICA-PSV, ΔICA-EDV and ΔICA-RI) and RI of VA (ΔVA-RI) in patient group were higher (all P<0.05), while the absolute value of slope ratio as slope 1/slope 2 in bilateral ICA and VA (LICA-SL1/SL2, RICA-SL1/SL2, LVA-SL1/SL2 and RVA-SL1/SL2) in patient group were lower than those in control group. ②ROC curve analysis in diagnosing ischemic cerebrovascular diseases showed that all of the areas under the curve (AUC) of ΔICA-PSV, ΔICA-EDV, ΔVA-RI and RICA-SL1/SL2 were above 0.7. ③Statistical differences of Dopplor waveform symmetry in ICA and VA were found between patient group and control group (all P<0.05). Conclusion The changes of hemodynamics in extracranial carotid artery are related to intracranial vascular diseases. Dopplor analysis of extracranial carotid arteries can predict the occurrence of intracranial ischemic cerebrovascular diseases.
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