Jargiello T, Pietura R, Rakowski P, Szczerbo-Trojanowska M, Szajner M, Janczarek M
Department of Interventional Radiology and Neuroradiology, University School of Medicine, Jaczewskiego 8, 20-950 Lublin, Poland.
Eur J Ultrasound. 1998 Dec;8(3):149-56. doi: 10.1016/s0929-8266(98)00067-6.
The recent introduction of Power Doppler Imaging (PDI) made a promise for better visualization of blood vessels lying in regions anatomically difficult for ultrasound imaging, i.e. vertebral arteries. The purpose of our study was to assess usefulness of PDI technique in visualization of vertebral artery course and to assess its utility in the detecting spondylotic vertebral artery compression in patients with vertebrobasilar insufficiency (VBI).
A total of 428 patients with VBI symptoms was evaluated. A total of 282 (66%) patients related their symptoms to a specific head position. Thus, all Doppler examinations were performed in four head positions: hyperextension, flexion and right/left rotation and also in a position reported by a patient to produce symptoms. PDI technique was employed as vertebral artery mapping for precise PW-Doppler range gate placing.
Vertebral artery compression was found in 73 (17%) patients: 65 unilateral and eight bilateral. The diagnosis was based on flow decrease or its absence shown on PW-Doppler scans, after a specific head turning.
Vertebral artery compression, related to a specific head position is relatively frequent in patients with VBI symptoms, especially in an older population commonly suffering from cervical spondylosis. PDI facilitates noninvasive Doppler US diagnosis by showing the real course of vertebral artery, particularly its intertransverse portion.
最近引入的能量多普勒成像（PDI）有望更好地显示解剖结构上超声成像困难区域的血管，即椎动脉。我们研究的目的是评估PDI技术在显示椎动脉走行方面的有用性，并评估其在检测椎基底动脉供血不足（VBI）患者椎动脉型颈椎病压迫方面的效用。
对总共428例有VBI症状的患者进行了评估。共有282例（66%）患者将其症状与特定头部位置相关联。因此，所有多普勒检查均在四个头部位置进行：过伸、屈曲以及右/左旋，还有患者报告可产生症状的位置。采用PDI技术进行椎动脉定位，以便精确放置脉冲波多普勒距离门。
在73例（17%）患者中发现椎动脉受压：65例单侧受压，8例双侧受压。诊断基于特定头部转动后脉冲波多普勒扫描显示的血流减少或血流消失。
与特定头部位置相关的椎动脉受压在有VBI症状的患者中相对常见，尤其是在通常患有颈椎病的老年人群中。PDI通过显示椎动脉的实际走行，特别是其横突间部分，有助于无创性多普勒超声诊断。
