摘要
目的观察脑静脉系统血栓(CVT)的脑静脉血流动力学变化。方法采用Doppler超声对患者进行脑静脉血流动力学前瞻性研究,测定51例患者(分3组)脑基底静脉(BVR)及其属支大脑中深静脉(DMCV)的最大平均血流速度(Vmax)。第一组为33例CVT,除诊断性探测外,对其中12例经过溶栓治疗者进行动态监测;第二组为11例存在颅内压增高而无CVT者;第3组为6例脑静脉窦结构变异而无CVT者。对3组患者均进行磁共振检查,并经数字减影血管造影或磁共振静脉血管成像证实诊断。结果第一组BVR和DMCV流速分别为( 64 6±22 9 )cm/s和( 70 7±28 6 )cm/s,明显高于正常值(P<0 01),但不受颅内压变化的影响(r=0 06, P>0 05),经溶栓治疗两静脉流速明显下降(P<0 01);第二组两静脉流速分别为(11 4±2 7)cm/s和(10 2±2 8 )cm/s,均在正常范围(P>0 05 ),不受颅内压变化的影响(r=0 053,P>0 05 );第三组两静脉流速分别为(12 0±4 6)cm/s和(11 1±6 8)cm/s,均在正常范围(P>0 05)。结论脑静脉血流动力学研究发现,BVR或DMCV血流速度代偿性增高是CVT特征性表现,不受颅内压增高及脑静脉窦结构变异的影响,可为CVT的早期诊断、病情监测和疗效观察提供可靠、无创和经济的检测手段。
Objective To observe the changes of hemodynamics in cerebral venous thrombosis (CVT).Methods Having aquired the normal flow velocities of basal vein of rosenthal (BVR) and deep middle cerebral vein (DMCV), we had a prospective study on hemodynamics of the same veins of 3 groups of patients. There were altogether 51 cases,the first group contained 33 cases with CVT , moreover, 12 patients receiving thrombolytic therapy among them were monitored. The second group contained 11 cases with intracranial hypertension without CVT. The third group contained 6 cases with cerebrovenous malformation without CVT. All of the three groups were detected by MRI, and the diagnosis were proved by DSA or MRV. We chose the venous (BVR or DMCV) maximum average flow velocity (Vmax) of each case as to managing data.Results In the first group , the Vmax of BVR and DMCV were (64.6±22.9) cm/s and (70.7±28.6) cm/s respectively, they were higher than normal values (P<0.01) and were not affected by intracranial pressure (r=0.06, P>0.05),and the Vmax of the same veins in patients with thrombolytic therapy was reduced obviously (P<0.01).In the second group, the Vmax of BVR and DMCV were (11.4±2.7) cm/s and (10.2±2.8) cm/s respectively, shown in a range of normal values (P>0.05), and were also not affected by intracranial pressure (r=0.053,P>0.05). In the third group, the Vmax of BVR and DMCV were (12.0±4.6) cm/s and (11.1±6.8 ) cm/s respectively, all were in a range of normal value (P>0.05).Conclusion The study of cerebrovenous hymodynamics found that the compensatory increase of the flow velocities of BVR and DMCV was the characteristics of CVT, and would not be affected by intracranial pressure and cerebrovenous malformation, which might provide a reliable, noninvasive and low-priced detecting method for earlier diagnosis, monitoring and evaluating the curative effects of CVT.
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2005年第2期101-103,共3页
Chinese Journal of Neurology
关键词
脑静脉
颅内血栓形成
血流动力学过程
血流速度
Cerebral veins
Intracranial thrombosis
Hemodynamics processes
Blood flow velocity
Ultrasonography, doppler
