首都医科大学学报 ›› 2014, Vol. 35 ›› Issue (2): 164-167.doi: 10.3969/j.issn.1006-7795.2014.02.005

• 超声医学 • 上一篇    下一篇

椎动脉发育不良患者后循环血流灌注量的CDFI研究

郭强1, 田家玮2, 罗伟华1, 陈道芳1, 徐芳1, 史登刚1   

  1. 1. 上海市第六人民医院金山分院超声医学科, 上海 201599;
    2. 哈尔滨医科大学附属第二医院超声医学科, 哈尔滨 150086
  • 收稿日期:2013-12-18 出版日期:2014-04-21 发布日期:2014-04-16
  • 基金资助:
    上海市金山区卫生计生委立项科研课题(JSKJ-KTMS-2013-05)。

Posterior cerebral circulatory blood perfusion in patients with vertebral artery hypoplasia by CDFI

Guo Qiang1, Tian Jiawei2, Luo Weihua1, Chen Daofang1, Xu Fang1, Shi Denggang1   

  1. 1. Department of Ultrasound in Medicine, Jinshan Branch of Shanghai No. 6 People's Hospital, Shanghai, 201599, China;
    2. Department of Ultrasound in Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
  • Received:2013-12-18 Online:2014-04-21 Published:2014-04-16
  • Contact: 田家玮 E-mail:jwtian2004@163.com
  • Supported by:
    This study was supported by Jinshan District Health and Family Planning Commission of Shanghai City(JSKJ-KTMS-2013-05).

摘要: 目的 评价椎动脉发育不良与脑动脉后循环血流灌注量的关系,为椎动脉发育不良患者后循环缺血性病变及症状提供血流动力学依据。方法 选取椎动脉发育不良患者53例,正常对照组60例,进行椎动脉超声检查,测量椎动脉内径(vertebral artery diameter,VAD),收缩期流速(peak systolic velocity,PSV),舒张期流速(end diastolic velocity,EDV),阻力指数(resistance index,RI),流速时间积分(velocity-time integral,VTI)、心率(heart rate,HR),并计算血管截面积(A)及血流量(Q),分析椎动脉发育不良对后循环血流灌注量的影响。结果 病例组后循环血流量为(299.83±58.52)mL/min,对照组为(351.26±49.17)mL/min,两组间比较,差异具有统计学意义(P<0.05);病例组发育不良侧椎动脉平均血流量(47.57±18.41)mL/min、舒张期流速(11.46±3.97)cm/s、阻力指数0.78±0.09,与健侧椎动脉及对照组左右侧椎动脉比较,差异有统计学意义(P<0.05);发育不良侧椎动脉的血流量与椎动脉内径呈高度正相关性(R2=0.887 8),而与阻力指数呈高度负相关性(R2=0.849 4)。结论 发育不良侧椎动脉的血流量明显减低,虽然健侧存在代偿,但后循环总血流灌注量仍较健康人显著减低,椎动脉发育不良是后循环缺血性病变的潜在危险因素。

关键词: 彩色血流显像, 椎动脉发育不良, 血流灌注量

Abstract: Objective To extend our knowledge of the congenital disease, this study attempted to assess the diagnostic value of posterior cerebral circulation in vertebral artery hypoplasia(VAH) detected by color Doppler flow imaging(CDFI), as well as to provide hemodynamic data for posterior circulation ischemia in VAH. Methods Fifty-three patients with vertebral artery hypoplasia and 60 healthy controls confirmed by color Doppler sonography were enrolled into this study. Vertebral artery diameter(VAD), peak systolic velocity(PSV), end diastolic velocity(EDV), resistance index(RI), velocity-time integral(VTI) and heart rate(HR) were measured. Vessel areas and blood flow volume were calculated. Variation of the difference of the results between the case and control groups was analyzed to assess the effect of congenital VA hypoplasia on posterior circulation. Results A comparison between the case and control groups showed that the blood flow of posterior circulation in case group was lower compared with the control group(299.83±58.52) mL/min vs (351.26±49.17) mL/min(P<0.05). The average blood flow of dysplasia side was(47.57±18.41) mL/min. Diastolic velocity was(11.46±3.97) cm/s and the resistance index was(0.78±0.09). There was statistical different between the dysplasia side and the contralateral normal side, and between the case and control groups(P<0.05). Moreover, the posterior circulation flow in the case group was positively correlated with the vertebral artery diameter(R2=0.887 8), and negatively correlated with the resistance index(R2=0.849 4). Conclusion Obviously reduced cerebral blood flow was associated with VAH. In spite of the existence of uninjured side compensation, the total perfusion of posterior circulation was still lower than that of the control group. Color Doppler sonography not only images the congenital morphologic variations of vertebral artery but also evaluates the reduced blood flow of posterior circulation(i.e. posterior circulation ischemia), which might become one of the hallmarks of VAH.

Key words: color Doppler flow imaging, vertebral artery hypoplasia, blood perfusion

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