Hu H H, Sheng W Y, Yen M Y, Lai S T, Teng M M
Department of Neurology, Taipei Veterans General Hospital, Yang-Ming Medical College, Taiwan, Republic of China.
Stroke. 1993 Aug;24(8):1196-203. doi: 10.1161/01.str.24.8.1196.
Distal to a hemodynamically significant stenosis, the Doppler effect becomes dampened. Thus, measuring the flow profile in the ophthalmic artery and the central retinal artery with color Doppler imaging may provide hemodynamic information about the carotid circulation.
To validate the flow profile measurement with color Doppler imaging in the ophthalmic and central retinal arteries and to determine the sensitivity and specificity of this examination in the detection of hemodynamically significant carotid stenosis, we compared color Doppler imaging examinations with ocular pneumoplethysmography and ophthalmodynamometry examinations in 66 patients with atherothrombotic ischemic cerebrovascular disease. The degree of carotid stenosis in these patients was determined by a duplex scan with color Doppler imaging, and 57 patients underwent angiography to verify the stenosis.
The flow velocities (systolic peak velocity and end-diastolic velocity) and pulsatility indices (A/B ratio and resistance index) in the ophthalmic and central retinal arteries decreased as the degree of carotid stenosis increased. There is a statistically significant difference in the mean of systolic peak velocity and the mean of end-diastolic velocity of the ophthalmic and central retinal arteries among groups with various degrees of carotid stenosis (P < .02). Using the flow velocities of the ophthalmic and central retinal arteries to diagnose carotid stenosis (> or = 75% stenosis and occlusion), 8 cm/s for systolic peak velocity in the central retinal artery and 29 cm/s for systolic peak velocity plus flow direction reversal in the ophthalmic artery gave the maximum accuracy (sensitivities, 84% and 85.7% and specificities, 89.6% and 81.7%, respectively). The systolic peak velocity in the central retinal artery varied directly with the systolic pressure of the ophthalmic and central retinal arteries.
The flow velocity and pulsatility in orbital arteries examined by color Doppler imaging provide further hemodynamic information; this test can be used to complement current sonographic examination of carotid disease.
在血流动力学显著狭窄的远端，多普勒效应会减弱。因此，用彩色多普勒成像测量眼动脉和视网膜中央动脉的血流剖面，可能会提供有关颈动脉循环的血流动力学信息。
为验证彩色多普勒成像测量眼动脉和视网膜中央动脉血流剖面的准确性，并确定该检查在检测血流动力学显著颈动脉狭窄方面的敏感性和特异性，我们对66例动脉粥样硬化性缺血性脑血管病患者进行了彩色多普勒成像检查，并与眼体积描记法和眼血流动力学检查进行了比较。这些患者的颈动脉狭窄程度通过彩色多普勒成像双功扫描确定，57例患者接受了血管造影以证实狭窄。
随着颈动脉狭窄程度的增加，眼动脉和视网膜中央动脉的血流速度（收缩期峰值速度和舒张末期速度）及搏动指数（A/B比值和阻力指数）降低。不同程度颈动脉狭窄组的眼动脉和视网膜中央动脉收缩期峰值速度均值及舒张末期速度均值存在统计学显著差异（P <.02）。以眼动脉和视网膜中央动脉的血流速度诊断颈动脉狭窄（≥75%狭窄和闭塞）时，视网膜中央动脉收缩期峰值速度为8 cm/s以及眼动脉收缩期峰值速度加血流方向逆转时为29 cm/s，准确性最高（敏感性分别为84%和85.7%，特异性分别为89.6%和81.7%）。视网膜中央动脉的收缩期峰值速度与眼动脉和视网膜中央动脉的收缩压直接相关。
彩色多普勒成像检查的眼眶动脉血流速度和搏动性提供了更多血流动力学信息；该检查可用于补充目前对颈动脉疾病的超声检查。
