Ghorbani Abbas, Ashtari Fereshteh, Fatehi Farzad
Neurology Department, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2010 May;15(3):133-9.
The goal of this study was to determine the reliability of TCD in evaluation of vertebrobasilar arteries in comparison with brain MRA in patients suffering from acute vertebrobasilar stroke.
Samples were patients with definite clinical diagnosis of vertebrobasilar stroke. For all patients brain MRI, MRA and TCD were performed during the first 48 hours of admission. Basilar artery was insonated at the depth of 75 to 85 mm and vertebral arteries were insonated at the depth of 45 to 55 mm. On brain MRA, the degree of stenosis in vertebrobasilar arteries was graded from I (normal) to IV (total stenosis) and the correlation between the grade of stenosis and TCD indices were studied.
Spearman correlation test revealed a significant correlation between mean flow velocity (MFV) and MRA grading (correlation coefficient = -0.486) as well as end diastolic velocity (EDV) and MRA grading (correlation coefficient = -0.323) with no significant correlation between pulsatility index, peak systolic velocity and MRA grading (p > 0.05). One way ANOVA analysis showed that there was only significant mean MFV and mean EDV difference between grade 1 and other grades.
TCD was only able to differentiate between stenotic and normal pattern and could not assist in the grading of stenosis. On the other hand, in acute vertebrobasilar stroke that TCD performed blindly without visualization of arteries and in a fixed depth it might have limited value in the grading of vertebrobasilar system stenosis.
本研究的目的是确定在急性椎基底动脉卒中患者中，经颅多普勒超声（TCD）与脑部磁共振血管造影（MRA）相比，评估椎基底动脉的可靠性。
样本为临床确诊的椎基底动脉卒中患者。所有患者在入院的头48小时内进行脑部MRI、MRA和TCD检查。在深度75至85毫米处探测基底动脉，在深度45至55毫米处探测椎动脉。在脑部MRA上，将椎基底动脉的狭窄程度从I级（正常）分级至IV级（完全狭窄），并研究狭窄分级与TCD指标之间的相关性。
Spearman相关性检验显示平均血流速度（MFV）与MRA分级之间存在显著相关性（相关系数 = -0.486），舒张末期速度（EDV）与MRA分级之间也存在显著相关性（相关系数 = -0.323），而搏动指数、收缩期峰值速度与MRA分级之间无显著相关性（p > 0.05）。单因素方差分析表明，仅I级与其他级别之间的平均MFV和平均EDV存在显著差异。
TCD仅能区分狭窄和正常模式，无法辅助狭窄分级。另一方面，在急性椎基底动脉卒中中，TCD在无法可视化动脉且探测深度固定的情况下盲目进行，在椎基底动脉系统狭窄分级方面可能价值有限。
