Baumgartner R W, Baumgartner I, Mattle H P, Schroth G
Department of Neurology, University of Bern, Inselspital, Switzerland.
AJNR Am J Neuroradiol. 1996 Apr;17(4):777-83.
To provide transcranial color-coded duplex flow-velocity data for the basal cerebral arteries in patients with unilateral flow-restrictive extracranial carotid artery disease, and to compare these data with the flow velocities obtained in healthy control subjects.
Transcranial color-coded duplex sonography was performed in 78 patients with different patterns of cross flow through the anterior and posterior communicating arteries associated with unilateral obstruction (70% to 100%; 46 stenoses and 32 occlusions) of the internal carotid arteries. Peak systolic, mean, and end diastolic velocities were measured in the anterior, middle, and precommunicating and postcommunicating posterior cerebral arteries. These measurements were compared with the values obtained in 125 age- and sex-matched health control subjects.
Patients with anterior communicating artery cross flow to the middle cerebral artery (63%) had increased peak velocity in the anterior cerebral artery and decrease peak velocity in the middle cerebral artery on the obstructed (ipsilateral) side, and increased peak velocity in the anterior cerebral artery on unobstructed (contralateral) side. Patients with anterior communicating artery cross flow to the pericallosal artery (19%) had increased contralateral peak systolic velocity and mean anterior cerebral artery velocities. Patients without anterior communicating artery cross flow (18%) had normal peak velocities in the anterior and middle cerebral arteries. Patients with posterior communicating artery cross flow (42%) had ipsilaterally decreased peak systolic and mean middle cerebral artery velocities and increased peak velocities in the precommunicating posterior cerebral artery. Patients without posterior communicating artery cross flow (58%) had ipsilaterally decreased peak systolic and mean middle cerebral artery velocities.
Our findings suggest that typical abnormalities of basal cerebral artery flow velocities occur in patients with unilateral 70% to 100% obstruction of the internal carotid arteries resulting in different patterns of cross flow through the circle of Willis.
为单侧血流受限的颅外颈动脉疾病患者提供大脑基底动脉的经颅彩色编码双功血流速度数据,并将这些数据与健康对照者获得的血流速度进行比较。
对78例伴有不同类型通过前、后交通动脉的交叉血流模式且伴有单侧颈内动脉阻塞(70%至100%;46例狭窄和32例闭塞)的患者进行经颅彩色编码双功超声检查。测量大脑前动脉、大脑中动脉以及大脑后动脉交通前段和交通后段的收缩期峰值、平均和舒张末期速度。将这些测量值与125例年龄和性别匹配的健康对照者获得的值进行比较。
前交通动脉向大脑中动脉交叉血流的患者(63%)在阻塞(同侧)侧大脑前动脉峰值速度增加,大脑中动脉峰值速度降低,在未阻塞(对侧)侧大脑前动脉峰值速度增加。前交通动脉向胼周动脉交叉血流的患者(19%)对侧收缩期峰值速度和大脑前动脉平均速度增加。无前交通动脉交叉血流的患者(18%)大脑前动脉和大脑中动脉峰值速度正常。后交通动脉交叉血流的患者(42%)同侧大脑中动脉收缩期峰值和平均速度降低,大脑后动脉交通前段峰值速度增加。无后交通动脉交叉血流的患者(58%)同侧大脑中动脉收缩期峰值和平均速度降低。
我们的研究结果表明,单侧颈内动脉70%至100%阻塞导致不同模式的 Willis 环交叉血流的患者中,大脑基底动脉血流速度出现典型异常。