Xing Jin, Xu Bin, Zhai Lin, Men Yan, Zhang Dan, Zhang Wenjing, Cui Jian
Department of Ultrasound, Capital Medical University, FuXing Hospital, Beijing, 100038, China.
Department of Neurology, Capital Medical University, FuXing Hospital, Beijing, 100038, China.
Curr Med Imaging. 2020;16(7):887-891. doi: 10.2174/1573405615666191007152625.
Background and Introduction: Collateral circulation is very crucial for the prognosis of stroke patients. Transcranial color-coded duplexsonography (TCCD) is used widely to evaluate the intracranial arterial blood flow. However, approximately 20% - 30% of the patients with cerebral infarction cannot be detected via TCCD due to the interruption of thickened temporal bones. We assessed the diagnostic efficacy of contrast-enhanced transcranial color-coded duplexsonography (CE-TCCD) in stroke patients with limited bone windows.
CE-TCCD was applied to 70 patients (51 males and 19 females) who presented with ischemic symptoms, to detect the openness of the anterior communicating artery (ACoA) and posterior communicating artery (PCoA) of the Willis ring before Computed Tomography angiography (CTA) or Magnetic Resonance Angiography (MRA) examination. The results from CETCCD is used to compare with CTA/MRA result to verify the diagnostic efficacy.
Forty-one communicating artery openings were detected by CE-TCCD, among which 37 were PCoA and 4 were ACoA. Among the 70 patients, 23 of 70 patients indicated severe stenosis within intracranial and/or extracranial arteries. Eighteen out of the 23 patients showed collateral circulation, accounting for 78.3% (18/23). Moderate stenosis were 23 cases in total, in which 7 cases showed collateral circulation, accounting for 30.4% (7/23). Slight stenosis were 24 cases in total, none of which showed collateral circulation.
In the stroke patients with limited bone windows, CE-TCCD can evaluate intracranial collateral circulation.
背景与引言：侧支循环对卒中患者的预后至关重要。经颅彩色编码双功能超声（TCCD）被广泛用于评估颅内动脉血流。然而，由于颞骨增厚中断，约20% - 30%的脑梗死患者无法通过TCCD检测。我们评估了对比增强经颅彩色编码双功能超声（CE-TCCD）在骨窗受限的卒中患者中的诊断效能。
对70例出现缺血症状的患者（51例男性和19例女性）应用CE-TCCD，在计算机断层扫描血管造影（CTA）或磁共振血管造影（MRA）检查前检测Willis环的前交通动脉（ACoA）和后交通动脉（PCoA）的开放情况。将CE-TCCD的结果与CTA/MRA结果进行比较以验证诊断效能。
CE-TCCD检测到41个交通动脉开放，其中37个为PCoA，4个为ACoA。在70例患者中，70例患者中有23例颅内和/或颅外动脉存在严重狭窄。23例患者中有18例显示有侧支循环，占78.3%（18/23）。中度狭窄共23例，其中7例显示有侧支循环，占30.4%（7/23）。轻度狭窄共24例，均未显示有侧支循环。
在骨窗受限的卒中患者中，CE-TCCD可评估颅内侧支循环。
