Baskett J J, Beasley M G, Murphy G J, Hyams D E, Gosling R G
Cardiovasc Res. 1977 Mar;11(2):147-55. doi: 10.1093/cvr/11.2.147.
The established test for disease in the internal carotid artery using continuous wave Doppler is to listen for flow velocity changes over the supraorbital artery with ipsilateral temporal (or facial) artery compression. This is only reliable when there is a reduction in mean pressure (and flow) distal to disease in the internal carotid artery, ie reduction of lumen diameter by more than 85%. In this study, 101 vessel segments (48 with disease at the carotid junction, 53 normal) were compared with the results of angiography. Seven gave a positive temporal artery occlusion test, all of which showed severe disease. However, spectral analysis of the Doppler signals from supraorbital and common carotid arteries showed sonagram changes both with ageing and with disease. In particular, the ratio of primary peak (A) to secondary peak (B) in systole falls, the A/B ratio being lower in disease than in health. At A/B ratios less than 1.05 there was an 88% probability of disease at the carotid junction. 36/48 (75%) diseased junctions were detected, including almost all major lesions. The method did not so reliably detect small lesions (less than 2 mm plaques, less than 60% lumen diameter stenosis, and 'minimal atheroma'). In 5/53 normal junctions the A/B ratio was in the disease range. Scanning the carotid junction for turbulence yielded additional information in some cases.
使用连续波多普勒检测颈内动脉疾病的既定方法是，在同侧颞（或面）动脉受压时，监听眶上动脉的血流速度变化。只有当颈内动脉病变远端的平均压力（和血流）降低时，即管腔直径缩小超过85%时，这种方法才可靠。在本研究中，将101个血管段（48个在颈动脉分叉处有病变，53个正常）与血管造影结果进行了比较。7个颞动脉闭塞试验呈阳性，所有这些都显示有严重病变。然而，对眶上动脉和颈总动脉的多普勒信号进行频谱分析发现，随着年龄增长和疾病发展，声谱图都会发生变化。特别是，收缩期主峰（A）与次峰（B）的比值下降，病变时的A/B比值低于健康状态。当A/B比值小于1.05时，颈动脉分叉处发生病变的概率为88%。检测到36/48（75%）个病变分叉处，包括几乎所有主要病变。该方法对小病变（小于2mm斑块、管腔直径狭窄小于60%以及“微小动脉粥样硬化”）的检测不太可靠。在5/53个正常分叉处，A/B比值处于病变范围内。在某些情况下，扫描颈动脉分叉处有无湍流可提供更多信息。
