Rosenkranz K, Langer R, Cordes M, Felix R
Department of Radiology, University Hospital Rudolf Virchow, Free University, Fed. Rep. of Germany.
Neurosurg Rev. 1992;15(1):37-44. doi: 10.1007/BF02352066.
Using noninvasive transcranial Doppler sonography, we studied cerebral collateral patterns in 30 patients with stenosis and/or occlusion of the extracranial internal carotid artery (ICA). All patients with unilateral ICA stenosis less than or equal to 80% had normal transcranial Doppler findings. 80% of patients with unilateral and 50% of patients with bilateral ICA stenosis of more than 80% including those with occlusion showed a collateralization via the ipsilateral anterior and/or posterior cerebral artery. 20% of patients with unilateral and 50% of patients with bilateral ICA stenoses of more than 80% (including occlusion) had two or three collateral pathways, including the ophthalmic artery. Another ten patients with stenosis or spasm of the middle cerebral artery (MCA) showed increased flow velocities with turbulence in the narrow segment. In four patients with severe MCA disease with a systolic peak velocity of more than 200 cm/s, the Doppler waveform distal to the lesion was damped. Decreased regional cerebral blood flow (rCBF) measured by 99mTc-HMPAO-SPECT was found in two patients with severe MCA stenosis. Another patient with moderate MCA stenosis with a systolic peak velocity of 140 cm/s showed a normal cerebral perfusion pattern.
我们使用无创经颅多普勒超声，研究了30例颅外颈内动脉（ICA）狭窄和/或闭塞患者的脑侧支循环模式。所有单侧ICA狭窄小于或等于80%的患者经颅多普勒检查结果均正常。80%的单侧ICA狭窄超过80%的患者以及50%的双侧ICA狭窄超过80%（包括闭塞）的患者，包括那些有闭塞情况的患者，显示通过同侧大脑前动脉和/或大脑后动脉形成侧支循环。20%的单侧ICA狭窄超过80%的患者以及50%的双侧ICA狭窄超过80%（包括闭塞）的患者有两条或三条侧支循环途径，包括眼动脉。另外10例大脑中动脉（MCA）狭窄或痉挛的患者，狭窄段血流速度增加且伴有湍流。在4例严重MCA病变且收缩期峰值速度超过200 cm/s的患者中，病变远端的多普勒波形减弱。通过99mTc-HMPAO-SPECT测量发现，2例严重MCA狭窄患者局部脑血流量（rCBF）降低。另1例中度MCA狭窄且收缩期峰值速度为140 cm/s的患者脑灌注模式正常。
