Babikian V L, Hyde C, Pochay V, Winter M R
Department of Neurology, Boston University School of Medicine, Mass.
Stroke. 1994 Aug;25(8):1570-3. doi: 10.1161/01.str.25.8.1570.
High-intensity transient signals detected by transcranial Doppler sonography have been associated with particulate cerebral emboli. Their clinical correlates are poorly understood. This study was undertaken to assess their relation to cerebral ischemia and to determine whether the severity of cerebral arterial stenosis has an impact on their occurrence.
We studied 96 arteries in 75 consecutive patients with extracranial or intracranial arterial lesions or potential cardiac sources of cerebral embolism. Sixty patients had histories of cerebral or retinal transient ischemic attacks or infarcts, and 15 were asymptomatic. The diagnosis of ischemia was based on the clinical presentation and was supported by extensive laboratory testing. A transcranial Doppler sonography unit equipped with special software for emboli detection was used. Signals were selected based on criteria established a priori.
Signals were detected in the territories of 28.3% of symptomatic and 11.6% of asymptomatic arteries. The difference was significant (P = .045). When patients with suspected cardiac embolic sources were excluded, the difference between symptomatic (27.9%) and asymptomatic (2.9%) arteries remained significant (P = .003), and signals were more frequent distal to arteries with more than 50% area stenosis (23.5%) than arteries with stenoses equal to or less than 50% (3.7%) (P = .028). In patients with only extracranial internal carotid artery stenoses, the difference between these degrees of stenosis remained significant (P = .043).
We conclude that high-intensity transient signals are significantly more common in the territories of symptomatic arteries and distal to lesions causing more than 50% stenosis. These findings may have diagnostic and therapeutic applications.
经颅多普勒超声检测到的高强度瞬态信号与脑微粒栓塞有关。但其临床相关性尚不清楚。本研究旨在评估它们与脑缺血的关系，并确定脑动脉狭窄的严重程度是否对其发生有影响。
我们研究了75例连续的患有颅外或颅内动脉病变或潜在心脏脑栓塞源的患者的96条动脉。60例患者有脑或视网膜短暂性脑缺血发作或梗死病史，15例无症状。缺血的诊断基于临床表现，并得到广泛实验室检查的支持。使用配备有特殊栓子检测软件的经颅多普勒超声设备。根据预先确定的标准选择信号。
在有症状动脉的供血区域检测到信号的比例为28.3%，无症状动脉为11.6%。差异有统计学意义（P = 0.045）。排除疑似心脏栓塞源的患者后，有症状动脉（27.9%）和无症状动脉（2.9%）之间的差异仍然显著（P = 0.003），且在面积狭窄超过50%的动脉远端检测到信号的频率（23.5%）高于狭窄等于或小于50%的动脉（3.7%）（P = 0.028）。在仅患有颅外颈内动脉狭窄的患者中，这些狭窄程度之间的差异仍然显著（P = 0.043）。
我们得出结论，高强度瞬态信号在有症状动脉的供血区域以及狭窄超过50%的病变远端明显更常见。这些发现可能具有诊断和治疗应用价值。
