Zwiebel W J
Department of Radiology, University of Utah Medical Center, Salt Lake 84132.
AJR Am J Roentgenol. 1992 Jan;158(1):29-36. doi: 10.2214/ajr.158.1.1727355.
This review considers the capabilities and limitations of duplex sonography in the diagnosis of abnormalities of the cerebral vasculature. Duplex sonography is an elegant union of B-mode and Doppler sonography that provides valuable information about atherosclerotic obstruction of the carotid arteries. Duplex sonography also can be used to evaluate, in a general way, the composition of carotid atherosclerotic plaque, and in this respect, it is unique among imaging procedures. Duplex sonography is not very effective in providing a "global" perspective of the cerebral vasculature, because only the cervical portion of the carotid arteries can be examined in detail. The best documented and most clearly effective use of duplex sonography is for detecting severe obstructive lesions in the carotid artery that might warrant endarterectomy in patients with cerebral hemispheric symptoms. The role of duplex sonography in the choice between medical and surgical therapy in asymptomatic patients with carotid artery stenosis is controversial, because the indications for endarterectomy are unclear in these patients. The capacity of duplex sonography to assess plaque composition may ultimately prove to be quite valuable for selecting therapeutic options and for evaluating the effectiveness of medical therapy. Meanwhile, information concerning the clinical value of this use of duplex sonography remains limited.
本综述探讨了双功超声在诊断脑血管系统异常方面的能力和局限性。双功超声是B型超声和多普勒超声的巧妙结合，可提供有关颈动脉粥样硬化性梗阻的有价值信息。双功超声还可用于大致评估颈动脉粥样硬化斑块的成分，在这方面，它在成像检查中独具特色。双功超声在提供脑血管系统的“整体”视角方面效果不佳，因为只能详细检查颈动脉的颈部部分。双功超声记录最完善且最明显有效的用途是检测颈动脉中可能需要对有脑半球症状的患者进行内膜切除术的严重梗阻性病变。对于无症状颈动脉狭窄患者，双功超声在药物治疗和手术治疗选择中的作用存在争议，因为这些患者的内膜切除术指征尚不清楚。双功超声评估斑块成分的能力最终可能被证明在选择治疗方案和评估药物治疗效果方面非常有价值。同时，关于双功超声这种应用的临床价值的信息仍然有限。
