[通过横断面分析进行的双功超声狭窄分级与磁共振断层扫描血容量流量定量在单侧颈内动脉狭窄中的相关性]

[Correlation of duplex sonographic stenosis grading by means of cross-sectional analysis and MR-tomographic blood volume flow quantification in unilateral stenosis of the internal carotid artery].

作者信息

Neff K W, Kilian A K, Meairs S, Düber C

机构信息

Institut für Klinische Radiologie, Universitätsklinikum Mannheim, Fakultät für Klinische Medizin Mannheim der Universität Heidelberg.

出版信息

Rofo. 2005 Jul;177(7):992-9. doi: 10.1055/s-2005-858288.

DOI:10.1055/s-2005-858288

PMID:15973602

Abstract

PURPOSE

Correlation of duplex ultrasonographic grading of unilateral internal carotid artery (ICA) stenosis and ICA blood volume flow (BVF) quantification.

MATERIALS AND METHODS

Using a 2D cine phase-contrast MR technique, 62 patients with unilateral ICA stenosis at the level of the bifurcation between 50 % and 98 % and 20 age-matched normal controls were examined. BVF was measured in the stenosed ICA. Ultrasonographic grading of stenoses was based on cross-sectional duplex sonography (color Doppler flow imaging [CDFI], real-time compound imaging) and compared to the changes in BVF in the stenosed ICA.

RESULTS

There was no statistically significant difference in BVF in stenoses of the ICA up to 70 % and in normal controls. ICA stenoses greater 70 % began to be hemodynamically relevant. With increasing stenosis, a decrease in BVF in the ipsilateral ICA was determined with a high and linear correlation of r = - 0.83. Normal controls showed a BVF in an ICA of 247.0 +/- 32.0 ml/min, patients with 70 % stenosis a mean BVF of 225.3 +/- 32.2 ml/min (P = 0.4) without significant reduction, patients with 80 % stenosis a significant reduction of BVF to a mean flow of 184.0 +/- 53.8 ml/min (P < 0.005), patients with 90 % stenosis a reduction of the mean BVF in the stenosed ICA to 84.6 +/- 41.9 ml/min (P < 0.0005) and patients with stenoses > 95 % a mean BVF of only 26.0 +/- 4.0 ml/min (P < 0.0005). In patients with unilateral ICA stenosis greater than 81 %, a significant decrease of BVF in the stenosed ICA was documented.

CONCLUSION

Comparison of ultrasonographic grading of unilateral ICA stenosis and BVF determination in patients with ICA stenoses demonstrate a high correlation between increase in the stenosis and decrease in the ipsilateral blood flow beginning at 70 % stenosis. ICA stenoses greater than 80 % are significantly hemodynamically relevant.

摘要

目的

探讨单侧颈内动脉（ICA）狭窄的双功超声分级与ICA血容量流量（BVF）定量之间的相关性。

材料与方法

采用二维电影相位对比磁共振技术，对62例单侧ICA狭窄程度在50%至98%之间且位于分叉处的患者以及20例年龄匹配的正常对照者进行检查。测量狭窄ICA的BVF。狭窄的超声分级基于横断面双功超声检查（彩色多普勒血流成像[CDFI]、实时复合成像），并与狭窄ICA的BVF变化进行比较。

结果

ICA狭窄程度达70%及以下者与正常对照者的BVF无统计学显著差异。ICA狭窄程度大于70%开始具有血流动力学意义。随着狭窄程度增加，同侧ICA的BVF降低，两者呈高度线性相关，r = - 0.83。正常对照者ICA的BVF为247.0±32.0 ml/min，狭窄70%的患者平均BVF为225.3±32.2 ml/min（P = 0.4），无显著降低；狭窄80%的患者BVF显著降低至平均流量184.0±53.8 ml/min（P < 0.005）；狭窄90%的患者狭窄ICA的平均BVF降至84.6±41.9 ml/min（P < 0.0005）；狭窄> 95%的患者平均BVF仅为26.0±4.0 ml/min（P < 0.0005）。在单侧ICA狭窄大于81%的患者中，记录到狭窄ICA的BVF显著降低。