Department of Radiology, SANKO University Hospital, Turkey.
Department of Neurology, SANKO University Hospital, Turkey.
Niger J Clin Pract. 2022 Nov;25(11):1883-1888. doi: 10.4103/njcp.njcp_326_22.
Carotid and vertebral Doppler ultrasonography (USG) is the primary diagnostic tool for the detection of extra cranial atherosclerotic disease and measurement of posterior fossa blood flow volume. The examination is performed while the patient lies on supine position. However, in daily practice we occasionally encounter patients who are not able to lie down on supine position for different reasons, such as kyphosis, severe dyspnea, or severe back pain.
We aimed to compare the doppler spectral measurements of carotid and vertebral arteries obtained in supine and sitting positions.
Fifty-three patients were recorded in the first group, to whom carotid and vertebral (CV) Doppler Ultrasound examination was initially performed while sitting, and another 52 patients were examined as the second group where initial measurements were done in a supine position. Peak systolic velocity (PSV), end diastolic velocity (ED) from each vessel, internal carotid artery (ICA)/common carotid artery (CCA) ratio, and volume flow of vertebral artery (VA) were measured in supine and sitting positions. Also, another 83 patients with a complaint of vertigo were included in the third group but only VA measurements were compared.
In the first group, there was a difference between sitting and supine positions in right ICA diastolic, right and left VA diastolic, and left CCA diastolic velocities (P < 0.05). In the second group, there was a difference in sitting and supine positions in right CCA systolic, right CCA diastolic, and left CCA diastolic velocities (P < 0.05). In the third group, there was a difference in sitting and supine positions in right and left VA diastolic velocities, left VA volume flow, and total VA volume flow (P < 0.05). A strong correlation was detected between supine and sitting positions regarding right and left ICA stenoses. Alterations in waveforms were noted in three patients' unilateral VAs, in supine and sitting positions.
Our results suggest that CV doppler examinations may be performed in the sitting positions. Examination in the sitting position may be helpful in recognizing pre-steal and retrograde flows.
颈动脉和椎动脉多普勒超声（USG）是检测颅外动脉粥样硬化疾病和测量后颅窝血流体积的主要诊断工具。检查时患者取仰卧位。然而，在日常实践中，我们偶尔会遇到因脊柱后凸、严重呼吸困难或严重背痛等原因无法仰卧的患者。
我们旨在比较仰卧位和坐位时颈动脉和椎动脉的多普勒频谱测量值。
将 53 例患者记录在第一组中，这些患者首先进行颈动脉和椎动脉（CV）多普勒超声检查，初始检查为坐位，另外 52 例患者作为第二组记录，初始测量为仰卧位。测量仰卧位和坐位时每个血管的收缩期峰值速度（PSV）、舒张末期速度（ED）、颈内动脉（ICA）/颈总动脉（CCA）比值和椎动脉（VA）容积流量。另外，还纳入了 83 例有眩晕症状的患者作为第三组，但仅比较 VA 测量值。
在第一组中，右侧 ICA 舒张期、右侧和左侧 VA 舒张期以及左侧 CCA 舒张期速度在坐位和仰卧位之间存在差异（P < 0.05）。在第二组中，右侧 CCA 收缩期、右侧 CCA 舒张期和左侧 CCA 舒张期速度在坐位和仰卧位之间存在差异（P < 0.05）。在第三组中，右侧和左侧 VA 舒张期速度、左侧 VA 容积流量和总 VA 容积流量在坐位和仰卧位之间存在差异（P < 0.05）。右侧和左侧 ICA 狭窄的仰卧位和坐位之间存在强相关性。在三名患者的单侧 VA 中，仰卧位和坐位时观察到波形改变。
我们的结果表明，CV 多普勒检查可以在坐位进行。坐位检查有助于识别预盗血和逆行血流。
