摘要
目的采用彩色多普勒影像(color doppler flow imaging,CDFI)和经颅多普勒超声(transcranialdoppler,TCD)评价颈动脉狭窄患者行颈动脉支架置入术(carotid artery stenting,CAS)的治疗效果。方法回顾分析经全脑血管造影(digital subtraction angiography,DSA)确诊具有脑缺血症状的颈动脉狭窄(狭窄率≥70%)且接受CAS治疗的患者41例,采用CDFI及TCD测量CAS治疗前、后颈动脉狭窄局部管径、狭窄率、狭窄段收缩期峰值流速(peak systolic velocity,PSV)及同侧大脑中动脉(MCA)的PSV、搏动指数(pulsatility in-dex,PI),并进行对比分析,同时与DSA结果进行对比。结果颈动脉狭窄患者行颈动脉支架置入术后原狭窄处内径明显增宽,原狭窄处内径由术前(1.88±0.75)mm增加至术后的(3.63±1.02)mm(P<0.01);颈动脉狭窄处PSV及患侧MCA的PSV、PI恢复正常,侧支循环全部关闭。颈动脉狭窄处PSV由术前(197.49±64.78)cm/s,降至术后的(82.62±36.48)cm/s(P<0.01);患侧MCA的PSV由术前(63.92±26.83)cm/s,术后升高(87.46±18.90)cm/s(P<0.01);MCA的PI值由术前0.67±0.35提高到0.89±0.17。结论 CDFI和TCD结果提示CAS后血管结构及血流动力学的改善,CDFI和TCD结合可以作为准确评价和随访CAS术后疗效的有效手段。
Objective To evaluate the efficacy of carotid stent implantation performed on patients with carotid stenosis by color doppler flow imaging （CDIF） and transcranial doppler （TCD）. Methods Forty-one carotid stenosis cases Ecarotid stenosis rate≥70%, confirmed by digital subtraction angiography （DSA）] who had cerebral ischemia symptoms and received stent implantation were reviewed. CDFI and TCD were adopted to measure the vessel diameter, carotid stenosis rate, peak systolic velocity （PSV） of the narrow segment, PSV and pulsatility index （PI） of ipsilateral middle cerebral artery （MCA） before and after the treatment of intravascular stents, and a comparison analysis was made. Results After the treatment of carotid stent implantation, the improvement of above indexes in patients with carotid stenosis were as following： （Dinner diameter of the narrow part became widened. The inner diameter was （1.88±0.75） mm before stenting and （3.63±0.02） mm after stenting （P〈0.01） ; （2） PSV of the narrow part and PSV, PI of the affected side MCA turned to be normal, and all the collateral circulations closed. Before stenting the PSV of the narrow part was （197.49±64.78） cm/s, after stenting it was （82.62±36.48） cm/s （P〈0.01）; PSV of the affected side MCA was （63.92±26.83） cm/s before stenting, and after stenting it was （87.46± 18.90） cm/s （P〈0. 01） PI of the affected side MCA from （0.67 ± 0.35） before stenting, increased to （0.89 ±0.17） after stenting. Conclusions The results of CDFI and TCD indicated that the treatment of endovascular stenting could improve the vascular structures and hemodynamics, the combination of CDFI and TCD could be used in the accurate assessment and follow up of carotid artery stenting treatment.
出处
《中国神经免疫学和神经病学杂志》
CAS
2011年第3期162-165,共4页
Chinese Journal of Neuroimmunology and Neurology
