Carroll B A
Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710.
J Ultrasound Med. 1989 Oct;8(10):535-40. doi: 10.7863/jum.1989.8.10.535.
Many patients with hemispheric neurologic symptoms do not have operative stenoses of the extracranial carotid arteries. In order to assess the frequency of such atherosclerotic lesions, 154 patients with documented hemispheric events underwent duplex Doppler examinations of the extracranial carotid bifurcation to assess if operative stenosis (70% to 80% stenosis) was present. Seventy-two patients with transient ischemic attacks (TIA), 62 patients with cerebrovascular accidents (CVA), and 20 patients with amaurosis fugax (AF) were studied. Sixty-nine percent of patients with TIAs demonstrated a less than 50% stenosis, 52% of patients with CVAs demonstrated a less than 50% stenosis, and 65% of patients with AF demonstrated a less than 50% stenosis on duplex Doppler examination. Intra-arterial digital subtraction angiography (IADSA) was performed in 35 of 154 patients. In all of these 35 cases, ultrasound and angiographic studies agreed with respect to whether or not a greater than 50% stenosis was present. Our findings support the use of duplex Doppler sonography as a triage procedure in patients with hemispheric events in order to determine those patients who have significant carotid stenoses and who may be potential operative candidates.
许多有半球神经症状的患者并无颅外颈动脉的手术性狭窄。为了评估此类动脉粥样硬化病变的发生率，154例有明确半球事件的患者接受了颅外颈动脉分叉处的双功多普勒检查，以评估是否存在手术性狭窄（70%至80%狭窄）。研究对象包括72例短暂性脑缺血发作（TIA）患者、62例脑血管意外（CVA）患者和20例一过性黑矇（AF）患者。双功多普勒检查显示，69%的TIA患者狭窄程度小于50%，52%的CVA患者狭窄程度小于50%，65%的AF患者狭窄程度小于50%。154例患者中有35例接受了动脉内数字减影血管造影（IADSA）。在这35例患者中，超声和血管造影检查在是否存在大于50%狭窄方面的结果一致。我们的研究结果支持将双功多普勒超声检查作为有半球事件患者的一种筛选方法，以确定那些有明显颈动脉狭窄且可能是潜在手术候选者的患者。
