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彩色多谱勒血流成像和经颅多谱勒超声对优势椎动脉后循环梗死患者血流动力学特征的评估。

Evaluation of hemodynamic characteristics in posterior circulation infarction patients with vertebral artery dominance by color doppler flow imaging and transcranial doppler sonography.

机构信息

Liaoning Province Jinqiu Hospital, Shenyang City, Liaoning Province, China.

The Seventh Department of Neurology, Liaoning Province People's Hospital, Shenyang City, Liaoning Province, China.

出版信息

Int J Neurosci. 2021 Nov;131(11):1078-1086. doi: 10.1080/00207454.2020.1773820. Epub 2020 May 29.

Abstract

PURPOSE

The aim of this study was to investigate the hemodynamic characteristics of posterior circulation infarction (PCI) patients with the vertebral artery dominance (VAD) using Color Doppler flow imaging (CDFI) and Transcranial Doppler sonography (TCD) and to explore the pathogenesis of PCI caused by VAD.

MATERIALS AND METHODS

A total of 186 consecutive PCI patients were enrolled. All the patients underwent magnetic resonance (MR) examination and the clinical data were collected. According to the brain magnetic resonance angiography (MRA), the patients were divided into VAD and non-VAD groups. CDFI and TCD were performed to identify the hemodynamic parameters of the vertebral artery (VA) and basilar artery (BA).

RESULTS

The male population was significantly more frequent in the VAD group (71.3%) as compared to the non-VAD group (53.1%). The significant difference in hemodynamic parameters was observed between VAD and non-VAD groups. Resistance index (RI) of extracranial and intracranial VA was different as well. There were also differences in the VA side-to-side diameter difference-value, peak velocity (Vp), mean velocity (Vm) and pulsatility index (PI) with varying degrees of BA curvature.

CONCLUSIONS

VA and BA hemodynamic changes caused by VAD may be an important risk factor in the process of occurrence of PCI. The combination of CDFI and TCD can help to detect the hemodynamic changes in the intracranial and extracranial segments of VA and BA. This can have important clinical value in understanding the pathogenesis of PCI.

摘要

目的

本研究旨在通过彩色多普勒血流成像(CDFI)和经颅多普勒超声(TCD)观察椎动脉优势(VAD)患者后循环梗死(PCI)的血流动力学特征,探讨 VAD 导致 PCI 的发病机制。

材料与方法

连续纳入 186 例 PCI 患者。所有患者均行磁共振(MR)检查并采集临床资料。根据脑磁共振血管造影(MRA)将患者分为 VAD 组和非 VAD 组。行 CDFI 和 TCD 检查,识别椎动脉(VA)和基底动脉(BA)的血流动力学参数。

结果

VAD 组男性(71.3%)明显多于非 VAD 组(53.1%)。VAD 组与非 VAD 组之间的血流动力学参数存在显著差异。颅外和颅内 VA 的阻力指数(RI)也不同。VA 两侧直径差值、峰值速度(Vp)、平均速度(Vm)和搏动指数(PI)也存在差异,BA 曲率程度不同。

结论

VAD 引起的 VA 和 BA 血流动力学变化可能是 PCI 发生过程中的一个重要危险因素。CDFI 和 TCD 相结合有助于检测 VA 和 BA 颅内外段的血流动力学变化,对了解 PCI 的发病机制具有重要的临床价值。

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