Niederkorn K, Myers L G, Nunn C L, Ball M R, McKinney W M
Department of Neurology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27103.
Stroke. 1988 Nov;19(11):1335-44. doi: 10.1161/01.str.19.11.1335.
We investigated 60 patients with cerebrovascular disorders using a three-dimensional transcranial Doppler blood flow mapping system. A composite display of the circle of Willis is created with computer assistance, allowing accurate vessel identification and optimal data documentation of blood flow velocity and direction in the basal cerebral arteries. The basilar artery was insonated in every patient; the middle cerebral artery and the most distal internal carotid artery were found in 95% of the patients, the anterior cerebral artery in 85%, and the posterior cerebral artery in 84%. Insonation problems occurred predominantly in elderly women. Transcranial Doppler blood flow mapping showed an abnormal result in 23 of 60 patients (38%). An intracranial stenosis with greater than 50% diameter reduction or occlusion was found in 10 of 31 patients (32%) with completed stroke, reversible ischemic neurologic deficit, or transient ischemic attack. Collateral blood flow mechanisms could be demonstrated in patients with extracranial carotid artery occlusions. Intra-arterial cerebral angiography performed in 21 patients confirmed the transcranial Doppler blood flow mapping diagnosis in 19 (90.5%). In one patient an arteriovenous malformation diagnosed by transcranial Doppler blood flow mapping was confirmed by magnetic resonance imaging.
我们使用三维经颅多普勒血流成像系统对60例脑血管疾病患者进行了研究。在计算机辅助下生成了 Willis 环的复合显示图，可准确识别血管，并对脑基底动脉的血流速度和方向进行最佳数据记录。每位患者均检测了基底动脉；95%的患者检测到大脑中动脉和最远端的颈内动脉，85%检测到大脑前动脉，84%检测到大脑后动脉。检测问题主要出现在老年女性中。经颅多普勒血流成像显示，60例患者中有23例（38%）结果异常。在31例完全性卒中、可逆性缺血性神经功能缺损或短暂性脑缺血发作患者中，10例（32%）发现颅内狭窄，直径缩小超过50%或闭塞。在颅外颈动脉闭塞患者中可显示侧支血流机制。21例患者进行了动脉内脑血管造影，其中19例（90.5%）证实了经颅多普勒血流成像诊断。在1例患者中，经颅多普勒血流成像诊断的动静脉畸形经磁共振成像得到证实。
