van Everdingen K J, Klijn C J, Kappelle L J, Mali W P, van der Grond J
Department of Radiology, University Hospital Utrecht, Netherlands.
Stroke. 1997 Aug;28(8):1595-600. doi: 10.1161/01.str.28.8.1595.
Flow measurements in the collateral arteries of patients with internal carotid artery (ICA) occlusions may be important to estimate the risk of future stroke. Quantitative flow measurements in cerebropetal vessels can be reliably assessed by means of magnetic resonance angiography (MRA).
Fifty-four patients with transient or minor ischemic neurological deficits and an angiographically proven ICA occlusion and 16 control subjects underwent two-dimensional phase-contrast MRA quantitative flow measurements through the common carotid arteries, basilar artery, ICAs, and middle cerebral arteries (MCA).
Patients with a unilateral ICA occlusion and a 0% to 69% stenosis of the contralateral ICA had increased flow in the contralateral ICA (P < .005) and in the basilar artery (P < .005) compared with control subjects. Even patients with a 70% to 99% stenosis contralateral to the ICA occlusion had increased flow in the ICA (P < .05) as well as increased flow in the basilar artery (P < .001). Total cerebropetal flow was not significantly different between these patients and control subjects. Patients with bilateral ICA occlusions had an increased flow in the basilar artery (P < .001), while the total cerebropetal flow was less than in control subjects (P < .001). In all patients, flow was decreased in the ipsilateral MCA (P < .001) and in the contralateral MCA (P < .05).
The contralateral ICA is the main supplying artery in patients with an ICA occlusion. Total cerebropetal flow decreases only when both ICAs are occluded. In patients with symptomatic ICA occlusions, an open contralateral ICA is probably important to retain the cerebral blood flow within normal limits.
测量颈内动脉（ICA）闭塞患者侧支动脉的血流情况对于评估未来发生卒中的风险可能具有重要意义。通过磁共振血管造影（MRA）能够可靠地评估向心性血管的血流定量情况。
54例有短暂性或轻度缺血性神经功能缺损且血管造影证实为ICA闭塞的患者以及16例对照者接受了二维相位对比MRA检查，以定量测量通过颈总动脉、基底动脉、颈内动脉和大脑中动脉（MCA）的血流情况。
与对照者相比，单侧ICA闭塞且对侧ICA狭窄0%至69%的患者，其对侧ICA（P <.005）和基底动脉（P <.005）的血流增加。即使是ICA闭塞对侧狭窄70%至99%的患者，其ICA血流（P <.05）以及基底动脉血流（P <.001）也增加。这些患者与对照者之间的总向心性血流无显著差异。双侧ICA闭塞的患者基底动脉血流增加（P <.001），而总向心性血流低于对照者（P <.001）。在所有患者中，同侧MCA血流减少（P <.001），对侧MCA血流减少（P <.05）。
在ICA闭塞患者中，对侧ICA是主要供血动脉。仅当双侧ICA均闭塞时，总向心性血流才会减少。对于有症状的ICA闭塞患者，开放的对侧ICA可能对于将脑血流量维持在正常范围内很重要。
