Mattle H, Grolimund P, Huber P, Sturzenegger M, Zurbrügg H R
Department of Neurology, University of Bern, Inselspital, Switzerland.
Arch Neurol. 1988 Mar;45(3):289-95. doi: 10.1001/archneur.1988.00520270067022.
The transcranial Doppler sonographic findings of 61 patients with middle cerebral artery (MCA) disease were compared with those of 535 controls. According to computed tomographic, angiographic, and/or autopsy findings, the patients were classified as having MCA occlusive lesions in the central (sphenoidal) part or in peripheral branches or MCA stenosis. With MCA lesions, the MCA flow velocity (FV) was reduced. At the same time the anterior cerebral artery FV increased because of collateral flow over leptomeningeal anastomoses. Central MCA lesions showed less marked changes than did peripheral lesions. In MCA stenosis a steep rise of MCA FV appeared inside the stenotic segment. If there was a high-grade stenosis or occlusion of the internal carotid artery, a collateral circulation over the anterior part of the circle of Willis was seen in addition to the changes caused by the MCA disease. From these hemodynamic changes, transcranial Doppler sonographic diagnostic criteria for MCA occlusive and stenotic lesions were established.
对61例大脑中动脉（MCA）疾病患者的经颅多普勒超声检查结果与535例对照者的结果进行了比较。根据计算机断层扫描、血管造影和/或尸检结果，将患者分类为中央（蝶骨）部分或外周分支存在MCA闭塞性病变或MCA狭窄。存在MCA病变时，MCA血流速度（FV）降低。同时，由于软脑膜吻合支的侧支血流，大脑前动脉FV增加。中央MCA病变的变化不如外周病变明显。在MCA狭窄时，狭窄段内的MCA FV出现急剧升高。如果颈内动脉存在高度狭窄或闭塞，除了MCA疾病引起的变化外，还可见Willis环前部的侧支循环。根据这些血流动力学变化，建立了MCA闭塞性和狭窄性病变的经颅多普勒超声诊断标准。
