Wechsler L R, Ropper A H, Kistler J P
Stroke. 1986 Sep-Oct;17(5):905-12. doi: 10.1161/01.str.17.5.905.
Doppler analysis of flow in intracranial arteries is now possible using a 2 MHz probe allowing sufficient penetration of bone to obtain signals noninvasively. Thirty-two normal subjects, and 11 patients with cerebrovascular diseases including vasospasm following subarachnoid hemorrhage, middle cerebral artery stenosis, and extracranial internal carotid artery stenosis were studied by transcranial Doppler. Increased peak velocity and spectral broadening of the reflected signal corresponded to clinical and angiographic evidence of middle cerebral artery vasospasm or stenosis. Decreased peak velocity and blunted waveforms occurred in the middle cerebral artery ipsilateral to severe extracranial internal carotid stenosis with poor crossfilling from the contralateral carotid artery. Abnormalities resolved following carotid endarterectomy. Transcranial Doppler identifies vasospasm or stenosis of the middle cerebral artery and may allow noninvasive evaluation of collateral flow across the anterior circle of Willis in patients with extracranial carotid artery stenosis.
现在，使用2兆赫探头对颅内动脉血流进行多普勒分析成为可能，该探头能够充分穿透颅骨，从而无创获取信号。对32名正常受试者以及11名患有脑血管疾病的患者进行了经颅多普勒研究，这些患者的疾病包括蛛网膜下腔出血后的血管痉挛、大脑中动脉狭窄以及颅外颈内动脉狭窄。反射信号的峰值速度增加和频谱增宽与大脑中动脉血管痉挛或狭窄的临床及血管造影证据相符。在严重颅外颈内动脉狭窄且对侧颈动脉交叉充盈不良的情况下，大脑中动脉同侧的峰值速度降低且波形变钝。颈动脉内膜切除术后异常情况得到缓解。经颅多普勒可识别大脑中动脉的血管痉挛或狭窄，并可能对颅外颈动脉狭窄患者 Willis 前循环的侧支血流进行无创评估。
