摘要
目的分析经颅多普勒超声(TCD)检测大脑前动脉(ACA)和前交通动脉(ACoA)变异的血流动力学特点。方法选择经MR血管成像(MRA)确诊的ACA或ACoA变异的患者62例(患者组),无血管变异的健康者48名(对照组)。应用TCD检测两组颅内外血管血流动力学的变化。结果①患者组中,48例为一侧大脑前动脉交通前段(ACA-A1)发育不良,细小侧ACA-A1血流速度为(61±16)cm/s,显著低于对照组的(86±15)cm/s;粗大侧ACA-A1血流速度为(125±12)cm/s,显著高于对照组,均P<0.01;细小侧血流速度约为粗大侧的1/2。②压迫对侧颈总动脉(CCA)后,双侧ACA-A1血流速度均有不同程度的增高。在细小侧压迫前、后收缩峰血流速度的比值(Vp后/Vp前)为3.10±0.50,显著高于对照组的1.93±0.24;粗大侧Vp_后/Vp_前为1.33±0.11,显著低于对照组,差异均有统计学意义,P<0.01。细小侧Vp_后/Vp_前为粗大侧的2倍以上。③9例为一侧ACA-A1缺如,健侧ACA-A1血流速度为(131±17)cm/s,显著高于对照组及同侧大脑中动脉的血流速度。57例ACA-A1细小或缺如侧的颈内动脉颅外段血流速度为(47±11)cm/s,显著低于对侧的(60±13)cm/s,P<0.01。④对5例ACoA缺如的患者,分别压迫同侧CCA,ACA血流信号均消失。结论根据双侧ACA压迫颈动脉试验前后的血流动力学的改变,结合颈内动脉颅外段血流速度及血流信号的强度、血流分布等辅助指标,TCD可初步诊断ACA或ACoA变异。
Objective To analyze the hemodynamic characteristics in detecting of anatomic variations of anterior cerebral artery （ACA） and anterior communicating artery （ACoA） with transeranial Doppler （TCD）. Methods Sixty-two patients with anatomic variations of ACA or ACoA （patient group） and 48 healthy subjects without variation （control group ） diagnosed by magnetic resonance imaging （MRA） and TCD were selected. The hemodynamic changes in extracranial and intracranial vessels in both groups were detected by TCD. Results （1）Forty-eight patients with unilateral hypogenesis of ACA-A1 in the patient group. The blood flow velocity of ACA-A1 on the hypogenetic sides was 61 ± 16 cm/s, it was significantly lower than 86 ± 15 cm/s in the control group; the blood flow velocity of ACA-A1 on the thick sides was 125± 12 cm/s, and it was significantly higher than that in the control group （ all P 〈 0.01 ）. The blood flow velocity on the thin sides was about 1/2 of that on the thick sides. （2）After pressing the contralateral CCA, the blood flow velocity of bilateral ACA-A1 increased to various degrees. The ratio of peak systohc blood flow velocity on the thin sides was 3.10 ± 0.50, and it was significantly higher than 1.93 ± 0.24 in the control group. The ratio on the thick sides was 1.33 ±0.11. It was significantly lower than that in the control group. There was significant difference （ P 〈 0.01 ）. The ratio on the thin sides was more than two times of that on the thick sides. （3）Nine patients with unilateral absence of ACA-A1, the blood flow velocity of contralateral ACA-A1 was 131 ± 17 cm/s, and it was significantly higher than that of the control group and the ipsilateral MCA blood flow velocity. The blood flow velocity of the extracranial internal carotid artery in 57 patients on the thin or absence sides of ACA-A1 was 47 ± 11 cm/s, and it was significantly lower than 60 ± 13 cm/s on the contralateral sides （P 〈0.01 ）. （4）The blood flow signals in 5 patients with t
出处
《中国脑血管病杂志》
CAS
2010年第9期454-458,共5页
Chinese Journal of Cerebrovascular Diseases
基金
2008年深圳市科技计划项目(200803236)
关键词
大脑前动脉
前交通动脉
磁共振血管成像
超声检查
多普勒
经颅
变异
Anterior cerebral artery
Anterior communicating artery
Magnetic resonance imaging
Ultrasonography, doppler, transcranial
Variation
