Davis P C, Nilsen B, Braun I F, Hoffman J C
AJNR Am J Neuroradiol. 1986 Nov-Dec;7(6):1059-64.
A prospective blind comparison was completed between duplex sonography and angiography of the vertebral arteries. Thirty-two vertebral arteries were studied for direction of flow, degree of origin plaque or stenosis, Doppler characteristics, and vessel size. The vertebral arteries were reliably identified by imaging their course from the subclavian artery into the transverse foramina and by identifying a Doppler signal similar in waveform to the internal carotid artery. With Doppler, a 90% accuracy was obtained for direction of blood flow. Nonvisualization of origins was primarily due to vessel depth and/or tortuosity. In 12 vessel origins that were well seen with both techniques, angiography and sonography agreed in two-thirds of the cases. In four cases, origin plaque was underestimated with duplex imaging. Interestingly, no Doppler frequency or velocity elevation was identified distal to significant stenoses. One false-positive diagnosis of occlusion occurred with sonography, in which a 99% origin stenosis resulted in no detectable Doppler signal. By comparing sonography with angiography, sonography was shown to be 80% accurate in determining vertebral artery size. Our preliminary results indicate that duplex scanning is a reasonably accurate screening technique for size, patency, and direction of blood flow in the vertebral arteries. Duplex evaluation of the vertebral artery origin was limited by vessel depth, tortuosity, and calcifications.
对椎动脉进行了双功超声检查与血管造影的前瞻性盲法比较。对32条椎动脉的血流方向、起始部斑块或狭窄程度、多普勒特征及血管大小进行了研究。通过显示椎动脉从锁骨下动脉进入横突孔的走行，并识别出与颈内动脉波形相似的多普勒信号，可可靠地识别椎动脉。利用多普勒技术，血流方向的准确率达90%。起始部未显影主要是由于血管深度和/或迂曲。在两种技术均能清晰显示的12个血管起始部中，血管造影与超声检查结果在三分之二的病例中一致。在4例病例中，双功成像低估了起始部斑块。有趣的是，在明显狭窄远端未发现多普勒频率或速度升高。超声检查出现1例假阳性闭塞诊断，其中99%的起始部狭窄未检测到多普勒信号。通过超声检查与血管造影的比较，超声检查在确定椎动脉大小方面的准确率为80%。我们的初步结果表明，双功扫描是一种对椎动脉大小、通畅情况及血流方向较为准确的筛查技术。对椎动脉起始部的双功评估受血管深度、迂曲及钙化的限制。
