摘要
目的探讨彩色多普勒血流显像（CDFI）和经颅彩色多普勒超声（TCCS）联合检测评价颅内段椎动脉（IVA）重度狭窄支架置入治疗前后及再狭窄的血流动力学变化及其临床价值。方法回顾性纳入2011年11月至2013年11月经CDFI和TCCS联合检测并行全脑DSA证实的IVA重度狭窄患者102例，比较支架治疗前、术后1周及术后3、6、12个月椎动脉颅内、颅外段收缩期峰值流速（PSV）、舒张期末流速（EDV）、IVA搏动指数（PI）及颅外段阻力指数（RI）、管径、频谱形态和血流动力学参数。根据随访12个月时TCCS结果，将患者进一步分为再狭窄组（16例）和无再狭窄组（86例）。结果（1）TCCS检测显示，支架置人术后1周狭窄段的PSV、EDV、PI较术前明显改善，分别为（109±40）比（258±63）cm／s、（47±18）比（132±45）cm／s、0．91±0．15比0．75±0．18，差异均有统计学意义（均P〈0．01）。再狭窄组的PSV、EDV在术后3—12个月逐渐升高，术后12个月与术后1周比较，差异均有统计学意义（均P〈0．01）；无再狭窄组的PSV、EDV在术后12个月与术后1周比较，差异无统计学意义（P〉0．05）。（2）CDFI检测显示，术后1周患侧颅外段的PSV、EDV较术前明显改善，分别为（64±15）cm／s比（51±15）cm／s、（24±6）cm／s比（19±7）cm／s（均P〈0．01），RI值和颅外段椎动脉管径逐渐改善，于术后12个月时达到最高[0．61±0．07比0．63±0．12，P=0．038；（3．6±0．4）mm比（3．4±0．5）mm，P=0．009]。结论CDFI与TCCS的联合应用可以客观评价IVA支架置人术前、术后颅外段及颅内段的血流动力学变化，为支架置入的有效性和再狭窄的影像学评估提供参考信息。
Objective To investigate color Doppler flow imaging （CDFI） and transcranial color-coded sonography （TCCS） for detection and evaluation of severe stenosis of intracranial vertebral artery （IVA） before and after stenting, as well as the hemodynamic changes of restenosis and their clinical value. Methods A total of 102 patients with severe stenosis of IVA confirmed by CDFI plus TCCS and DSA from November 2011 to November 2013 were analyzed retrospectively. Extra- and intracranial segments peak systolic velocity （PSV） , end-diastolic velocity （ EDV）, IVA pulsatility index （ PI）, extracranial resistance index （RI） , tube diameter, spectrum morphology, and hemodynamic parameters before stenting and 1 week, 3,6 and 12 months after stenting were compared. According to the results of TCCS, they were further divided into either a restnosis group （ n = 16 ） or a non-restnosis group （ n = 86 ）. Results （ 1 ） The results of TCCS detection showed ： PSV, EDV, and PI of the stenotic segments were improved significantly at 1 week after stenting,they were 109 ± 40 cm/s vs. 258 ±63 cm/s,47 ± 18 cm/s vs. 132 ±45 cm/s,0.91 ± 0.15 vs. 0. 75 ±0.18, respectively. There were significant differences （ all P 〈 0.01 ）. PSV and EDV of the restenosis group were increased gradually from 3 to 12 months after procedure. There were significant differences between 12 months after procedure and one week after procedure （ all P 〈 0.01 ）. There were no significant differences in PSV,EDV,and PI of the non-restenosis group between the 12-month observation period after procedure and one week after procedure （ P 〉 0.05 ）. （2） The results of CDFI showed ： PSV and EDV of the ipsilateral extracranial segment were improved significantly after procedure compare with those before procedure, they were 64 ± 15 cm/s vs. 51 ± 15 cm/s and 24 ± 6 cm/s vs. 19 ± 7 cm/s （all P 〈 0.05）. The RI value and vertebral artery diameter of the extracranial segment were improved gradually, and they
出处
《中国脑血管病杂志》
CAS
CSCD
北大核心
2015年第8期404-408,共5页
Chinese Journal of Cerebrovascular Diseases
关键词
颅内椎动脉
支架
狭窄
再狭窄
彩色多普勒超声
经颅彩色多普勒超声
血流动力学
Intracranial vertebral artery
Stents
Stenosis
Restenosis
Color Doppler ultrasound
Transcranial color Doppler uhrasound
Hemodynamics
