Kimura K, Yonemura K, Terasaki T, Hashimoto Y, Uchino M
Department of Cerebrovascular Disease, Kumamoto City Hospital, Japan.
AJNR Am J Neuroradiol. 1997 Sep;18(8):1447-52.
To distinguish between acute complete unilateral cardioembolic and atherothrombotic internal carotid artery (ICA) occlusion by using duplex carotid sonography.
We studied 11 patients with cardioembolic ICA occlusion (CE group), 32 patients with atherothrombotic ICA occlusion (AT group), and 25 patients with normal angiographic findings (control group). We obtained B-mode scans and measured the end-diastolic flow velocity (EDV) in both common carotid arteries within 3 days of the onset of symptoms. Side-to-side ratios of EDV (ED ratio) were calculated by dividing the flow velocity on the unaffected side by that on the affected side.
In the AT group, the proximal ICA was full, with a large area of heterogeneous and partially calcified plaque, and the EDV (10.9 +/- 6.1 cm/s) was significantly lower than that in the control group (20.3 +/- 6.0 cm/s). The ED ratio was greater than 1.4 in all but one patient. In three patients in the CE group, B-mode scans showed a mobile, echogenic intravascular structure in the proximal ICA. The EDV (1.8 +/- 3.4 cm/s) was significantly lower than that in the control and AT groups. The ED ratio was greater than 1.4 in all cases.
We conclude that B-mode scans and the EDV in the common carotid artery can help to distinguish between acute cardioembolic and atherothrombotic ICA occlusion.
运用双功能颈动脉超声检查区分急性完全性单侧心源性栓塞和动脉粥样硬化血栓形成性颈内动脉（ICA）闭塞。
我们研究了11例心源性栓塞性ICA闭塞患者（CE组）、32例动脉粥样硬化血栓形成性ICA闭塞患者（AT组）以及25例血管造影结果正常的患者（对照组）。在症状发作3天内，我们获取了B型扫描图像并测量了双侧颈总动脉的舒张末期血流速度（EDV）。通过将未受影响侧的血流速度除以受影响侧的血流速度来计算EDV的双侧比值（ED比值）。
在AT组中，ICA近端充盈，存在大面积不均匀且部分钙化的斑块，EDV（10.9±6.1厘米/秒）显著低于对照组（20.3±6.0厘米/秒）。除1例患者外，所有患者的ED比值均大于1.4。在CE组的3例患者中，B型扫描显示ICA近端有一个可移动的、回声增强的血管内结构。EDV（1.8±3.4厘米/秒）显著低于对照组和AT组。所有病例的ED比值均大于1.4。
我们得出结论，B型扫描和颈总动脉的EDV有助于区分急性心源性栓塞和动脉粥样硬化血栓形成性ICA闭塞。
