Grolimund P, Seiler R W, Aaslid R, Huber P, Zurbruegg H
Department of Neurosurgery, University Hospital, Bern, Switzerland.
Stroke. 1987 Nov-Dec;18(6):1018-24. doi: 10.1161/01.str.18.6.1018.
Results from 1,039 combined cervical and transcranial Doppler examinations are reported. Satisfactory transcranial signals were not found in 2.7% of the cases. Compared with angiography, the accuracy of transcranial criteria in assessing collateral flow over the circle of Willis was 94 and 88% for anterior and posterior circulation, respectively. The method also appeared very promising for detection of lesions of the intracranial arteries although the number of such cases with angiographic verification was limited in the present series. Arterial narrowing due to cerebral vasospasm was diagnosed with a sensitivity of 80%. In patients with ruptured intracranial aneurysms, an incidence of 93% arterial narrowing in basal cerebral arteries was found. Patients with subarachnoid hemorrhage and no aneurysm on angiography also showed arterial narrowing with an incidence of 56%. It was possible to monitor the time course and severity of cerebral vasospasm. Arteriovenous malformations were characterized by Doppler findings of high velocities and low pulsatilities. These lesions were diagnosed with an accuracy of 95%.
报告了1039例经颈和经颅多普勒联合检查的结果。2.7%的病例未发现满意的经颅信号。与血管造影相比，经颅标准评估 Willis 环侧支血流的准确性在前循环和后循环中分别为94%和88%。尽管本系列中经血管造影证实的此类病例数量有限，但该方法在检测颅内动脉病变方面似乎也很有前景。诊断脑血管痉挛所致动脉狭窄的敏感性为80%。在颅内动脉瘤破裂的患者中，发现基底脑动脉狭窄发生率为93%。血管造影无动脉瘤的蛛网膜下腔出血患者也显示动脉狭窄，发生率为56%。可以监测脑血管痉挛的时间进程和严重程度。动静脉畸形的特点是多普勒检查发现血流速度高、搏动性低。这些病变的诊断准确率为95%。
