【作者】 沈敏海； 任志红； 林棋；

【Author】 Shen Min Hai,Ren Zhi Hong, Lin Qi.Longyan First Hospital, Longyan City, Fujian 364000

【机构】 福建省龙岩市第一医院；

【摘要】 目的 比较椎动脉彩色多普勒超声(CDFI)与磁共振血管造影(MRA)二种无创伤技术对推-基底供血不足(VBI)椎动脉血流动力学改变、动脉血管壁情况的诊断意义及应用中的各自优势.方法 65例符合临床诊断标准的VBI患者接受颅外段CDFI与MRA检查,主要观察椎动脉管径、收缩期流速、平均流速、管壁内膜动脉硬化程度.结果 65例VBI患者49例(75%)存在CDFI椎动脉异常改变,最常见的异常改变为椎动脉缺血与狭窄,其次为动脉内膜斑块,阻力指数增高等改变.65例VBI患者中32例(46%)存在MRA动脉异常改变,最常见为椎动脉狭窄,其次为动脉硬化改变.CDFI与MRA仅在椎动脉狭窄方面符合率较高.结论 CDFI与MRA均为颅外段椎动脉硬化病变无创检查的有效手段.CDFI在血流动力学监测、观察血管壁情况方面有明显优势,检查费用低廉,重复性好,可作为VBI患者首选筛查性影像诊断手段.MRA具有椎动脉整体显示良好、双侧椎动脉同时显示、易于对比等优点,二者联合应用必将显著提高椎动脉病变的诊断敏感性与特异性.更多还原

【Abstract】 Objectives Compare the two noninvasive screening method of CDFI and 3D - MRA, and to determine the accuracy of the morphological structure and hemodyramic changes of vertebraeartery in VBI. Method 65 cases of VBI recived the examination of CDFI and MRI, mainly be observed the vessel diameter of vertebra artery, MAX, MIN, the arteriosclerosis in intima of VA and to find morphological changes. Results 49 cases(75%) of the 65 VBI exist abnormal changes in CDFI. The most common abnormal changes are the ischemia and vertebra artery stenosis. The second are endarterium plaques and the increase of resistence index. While 32 cases(46% ) of the 65 VBI exist abnormal changes in MRA.The most common is the vertebra artery stenosis, the second is the change of arteriosclerosis. The coincidence rate is only higher in the stenosis of VA. Conclusion Both CDFI and MRA are effective methods of noninvesive examination in the VA. CDFI has notable advantage in monitoring the hemodyra-mic changes and observing the morphological structure of VA. Its examination cost is low. Therefore it is the first choice for the VBI. MRA has the merits in its fine complely display of VA, display of both sides of VA at the same time. The combined application of the CDFI and MRA will remarkably improve the assessment sensitivity and specificity of the abnormal changes of VA.更多还原