Zbornikova V, Lassvik C
Department of Neurology, University Hospital, Linköping, Sweden.
Neurol Res. 1996 Dec;18(6):521-7. doi: 10.1080/01616412.1996.11740465.
The aim was to study a relationship between the flow pattern in the ophthalmic artery (OA), the siphon and vessels within the circle of Willis. 27 patients, 22 males and 5 females, mean age 63 +/- 15 years (SD) with unilateral occlusion of the internal carotid artery (ICA) were examined by 3-dimensional Transcranial Doppler scanner. Flow signals from the OA, the siphon and intracranial vessels were registered before and after i.v. injection of 1 g acetazolamide. Pathological flow pattern was found in 18 patients in the OA on the occluded side consisting of 12 retrograde and 6 isoelectric flow directions. After acetazolamide injection retrograde systolic velocities (SV) increased significantly (p < 0.01), but anterograde velocities remained unchanged as did 3 isoelectric flow patterns, 2 turned to retrograde and one to anterograde flow direction. In the siphon lower resting anterograde mean velocities (MV) were found on both sides (p < 0.05) compared to normal subjects. Six patients had the same retrograde flow as in the OA. After acetazolamide MV in the siphon increased (p < 0.01) only on the nonoccluded side. Baseline retrograde ophthalmic SV and MV in the siphon correlated (p < 0.01 and p < 0.05 respectively) with MV in the middle cerebral artery (MCA) according to linear regression analysis (r = 0.78 and 0.59 respectively). All patients, having impaired vasomotor reactivity (VMR) < or = 11% in the anterior cerebral artery (ACA) on the occluded side, had pathological flow pattern in the OA. Patients with greatest difference (delta) between MV in the ACA on the nonoccluded and occluded side had a tendency to anterograde flow (r = 0.56, p < 0.05). Pulsative index (PI) in the ACA on the occluded side was lowest in the category with retrograde flow in the OA (0.67 +/- 0.14) and differed (p < 0.05) from normals and from the category with isoelectric and anterograde flow. Correlation of retrograde flow direction in the OA and baseline MV in the MCA and low PI in the ACA on the occluded side indicates a supplying ophthalmic collateral to the anterior brain circulation. Impaired VMR in the ACA on the occluded side in connection with pathological flow pattern in the OA may reflect an exhaustion of the ACA as a supplying vessel.
目的是研究眼动脉（OA）、虹吸段及 Willis 环内血管的血流模式之间的关系。对 27 例患者（22 例男性，5 例女性，平均年龄 63±15 岁[标准差]）进行了三维经颅多普勒扫描仪检查，这些患者均有单侧颈内动脉（ICA）闭塞。在静脉注射 1g 乙酰唑胺前后，记录 OA、虹吸段及颅内血管的血流信号。在闭塞侧的 OA 中，18 例患者发现了病理性血流模式，其中 12 例为逆向血流方向，6 例为等电位血流方向。注射乙酰唑胺后，逆向收缩期速度（SV）显著增加（p<0.01），但正向速度保持不变，3 种等电位血流模式中，2 种转变为逆向血流方向，1 种转变为正向血流方向。与正常受试者相比，虹吸段两侧静息时的正向平均速度（MV）较低（p<0.05）。6 例患者在虹吸段的血流方向与 OA 相同。注射乙酰唑胺后，仅在非闭塞侧虹吸段的 MV 增加（p<0.01）。根据线性回归分析，OA 基线逆向 SV 和虹吸段 MV 与大脑中动脉（MCA）的 MV 分别相关（p 分别<0.01 和 p<0.05）（r 分别为 0.78 和 0.59）。所有在闭塞侧大脑前动脉（ACA）血管运动反应性（VMR）受损≤11%的患者，在 OA 中均有病理血流模式。非闭塞侧和闭塞侧 ACA 的 MV 差异最大（δ）的患者有正向血流倾向（r = 0.56，p<0.05）。在 OA 中逆向血流的类别中，闭塞侧 ACA 的搏动指数（PI）最低（0.67±0.14），与正常以及等电位和正向血流类别不同（p<0.05）。OA 中的逆向血流方向与 MCA 的基线 MV 以及闭塞侧 ACA 的低 PI 之间的相关性表明，存在一条供应前脑循环的眼侧支循环。闭塞侧 ACA 的 VMR 受损并伴有 OA 中的病理血流模式，可能反映了 ACA 作为供应血管的功能耗竭。
