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1、经颅多普勒诊断脑血管痉挛的对比分析【摘耍】目的通过应用经颅多普勒(TCD)检测蛛网膜下腔出血患者的颅内血流状况，诊断脑血管痉挛(CVS)并经过数字减影血管造影(SDC)证实，说明TCD诊断CVS的可靠性。方法应用TCD检测2000-2005年CT已经明确诊断为蛛网膜下腔出血I'III级患者49例(1广V级患者病情严重不宜做血管造影检查，因此不做讨论)。于患病后第1天开始，每隔3d监测一次，动态观察10d。观察血管参数：大脑中动脉(MCA)、颈内动脉终末段(TICA)、颈内动脉颅外段(ICA)的收缩期峰值流速(Vs)、平均血流速度(Vm)以及大脑中动脉与颈内动脉颅外段(ICA)峰值流速
2、的比值(VMCA/VICA),同时行SDC检查证实。结果49例患者中，TCD提示CVS者26例，痉挛条数33条。数字减影血管造影结果显示CVS者31例，痉挛条数36条，TCD诊断CVS的敏感率为83.8%,TCD诊断CVS特异性为91.6%。结论TCD技术与SDC相比具有操作简便、价廉、实时无创、敏感有效，容易重复检查等优点。【关键词】经颅多普勒；脑血管痉挛；数字减影血管造影TranscranialDopplerindiagnosisofcerebralvasospasm-AcomparativestudyMAFeng-chun.BeijingMiyunCountyHospitail,
3、101500,China[Abstract]ObjectiveThepurposeofthisstudyistoevaluateintracranialbloodflowconditionsinpatientswithsubarachnoidhemorrhagewithtranscranialDoppler(TCD),andtoinvestigatethereliabilityofTCDindiagnosisofcerebralvasospasm(CVS)bycomparingwiththesubtractiondigitalangiography(SDC)result.Methods
4、49patientswhounderwentTCDexaminationbetween2000and2005wereinvolvedinthisstudy.AllthepatientshadappearanccofsubarachnoidhemorrhageforgradeI、IIIoncomputerizedtomography(CT)scan(gradeIVVwereexcludedbecausetooserioustoendureangiography)・Fromthefirstdayofmakingadefinitediagnosis,TCDwereperformedevery
5、threedays,andtheobservationlastedfortendays.Evaluatedparametersincluded:ThePeakandmeanvelocity(VsandVm)ofMiddlecerebralartery(MCA),Distaiinternalcarotic!artery(TTCA)andExtracranialinternalcarotidartery(EICA).RatioofMCAandEICA(VMCA/VICA)wascalculated,andSDCforeachpersonwerealsoperformed.ResultsAm
6、ongthe49patients,TCDsuggested26wereCVS,and33vasospasmvesselsintota1.SDCresultsshowedtherewere31CVSpatients,and36vasospasmvesselsintotal.SpecificationofTCDinCVSdiagnosiswas83.8%,andthespecificationwas91.6%.ConclusionComparedwiththeSDC,TCDhasitsaclvantagesforflexibleoperations,lowcost,real-timeand
7、non—invasive,sensitiveandeffective,andgoodreproducibility.【Keywords]TranscranialDoppler;Vasospasm;SubtractiondigitalangiographyCVS是脑出血、蛛网膜下腔出血和重度颅脑损伤的严重并发症，严重的CVS可以引起脑缺血、脑梗塞及神经功能障碍，甚至死亡，因此早期诊断CVS非常重要。1资料与方法1.1研究对象选择本院2000-20
