Kerty E, Nyberg-Hansen R, Hørven I, Bakke S J
Department of Neurology, National Hospital, University of Oslo, Norway.
Acta Neurol Scand. 1995 Aug;92(2):173-7. doi: 10.1111/j.1600-0404.1995.tb01035.x.
Assessing the adequacy of collateral circulatory pathways has become increasingly important in the investigation of cerebral circulation. Using transorbital Doppler ultrasonography (TOD), we examined the ophthalmic artery (OA) in patients with hemodynamic significant internal carotid artery (ICA) occlusive disease. The velocity and the direction of flow in the OA were studied in 45 patients (occlusion n = 27, stenosis > 75% n = 18), and in 30 age matched controls, under baseline conditions and within 30 minutes after the i.v. administration of 1 g acetazolamide as a vasodilatory stimulus. Based on the direction of flow before and after acetazolamide, the 45 patients could be separated into four groups with increasing degree of ICA lesions. In group I the OA flow was anterograde, but the velocity decreased after acetazolamide. In group II the OA direction became retrograde after acetazolamide, indicating collateral flow to the brain. In patients with retrograde OA flow following acetazolamide injection (group II-IV), the vessel reacted similarly to an intracranial artery, with marked increase in velocity when vasoreactivity was tested. TOD and the acetazolamide test provide useful information about potential collateral OA flow to the brain in patients with ICA occlusive disease.
在脑循环研究中，评估侧支循环途径的充分性变得越来越重要。我们使用经眶多普勒超声检查（TOD），对血流动力学上有意义的颈内动脉（ICA）闭塞性疾病患者的眼动脉（OA）进行了检查。在基线条件下以及静脉注射1g乙酰唑胺作为血管舒张刺激后30分钟内，对45例患者（闭塞组n = 27，狭窄> 75%组n = 18）和30例年龄匹配的对照组的OA血流速度和方向进行了研究。根据乙酰唑胺给药前后的血流方向，45例患者可分为四组，ICA病变程度逐渐增加。在第一组中，OA血流为顺行性，但乙酰唑胺给药后速度降低。在第二组中，乙酰唑胺给药后OA方向变为逆行性，表明有向脑的侧支血流。在注射乙酰唑胺后OA血流为逆行性的患者（第二至四组）中，该血管对血管反应性测试的反应与颅内动脉相似，速度显著增加。TOD和乙酰唑胺试验为ICA闭塞性疾病患者潜在的向脑侧支OA血流提供了有用信息。
