经颅彩色多普勒超声联合经颅超声造影诊断椎-基底动脉狭窄性中枢性眩晕的临床价值

涂滨，梁彤，石星，庞熙楹，林晖

（广州中医药大学附属佛山市中医院，广东 佛山，528000）

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摘要：

目的 探讨经颅彩色多普勒超声（TCCS）与经颅超声造影（CE-TCCS）联合应用评价椎-基底动脉（VBA）狭窄性中枢性眩 晕患者血流动力学改变的临床价值。方法 选取诊断为中枢性眩晕的患者35 例为研究对象，所有患者均进行TCCS、CE-TCCS 检查，并于一周内进行数字减影血管造影检查证实。分别计算两种检查方法的敏感度及特异度，并比较血管狭窄程度约50% 与跃50%的流速差异。结果35 例患者共105 支血管，DSA 显示跃50%狭窄的血管共40 支，闭塞血管12 支；TCCS 诊断椎-基底动 脉跃50%狭窄的敏感度为70.0%，特异度为71.7%（P<0.01），诊断闭塞的敏感度为66.7%，特异度为73.6%（P<0.01）；CE-TCCS 诊断椎-基底动脉跃50%狭窄的敏感度为92.5%，特异度为90.6%（P<0.01），诊断闭塞的敏感度为91.7%，特异度为94.3% （P<0.01）；跃50%狭窄组血管的PSV、EDV 及MFV 均明显高于约50%狭窄组（P<0.01），而两组间PI 值无明显差异（P=0.368）。结论 TCCS 联合CE-TCCS 检查可提高椎-基底动脉狭窄闭塞病变的诊断准确率，可应用于中枢性眩晕患者的常规筛查。

 

关键词：经颅彩色多普勒超声；经颅超声造影；椎-基底动脉；中枢性眩晕

中图分类号：R743.1 文献标志码：A文章编号：2096-1413(2017)01-0001-03

 The clinical valve of transcranial color-coded sonography and contrast-enhanced
transcranial color-coded sonography in diagnosing vertebral-basilar artery
stenosis central vertigo
TU Bin, LIANG Tong, SHI Xing, PANG Xi-ying, LIN Hui
(Foshan Hospital of TCM, the Affiliated Hospital of Guangzhou University of Chinese Medicine, Foshan 528000, China)
 
ABSTRACT: Objective To investigate the clinical value of transcranial color -coded sonography (TCCS) and contrast -enhanced transcranial color -coded sonography (CE -TCCS) in diagnosing the hemodynamics changes of patients with vertebral-basilar artery stenosis central vertigo. Methods Thirty-five cases of patients with central vestibular vertigo were selected as the study objects. All the patients were taken with TCCS and CE -TCCS examination, and accepted digital subtraction angiography examination within one week. The sensitivity and specificity of two methods were calculated, and the difference of flow rate between <50% and >50% was compared. Results There were 35 patients with 105 vessels, the DSA showed that the >50% stenosis were 40 branches and the vaacular occlusion were 12 branches. The sensitivity and specificity of TCCS in diagnosing vertebral - basilar artery stenosis >50% were 70.0% and 71.7% (P<0.01); the sensitivity and specificity of TCCS in diagnosing blocking were 66.7% and 73.6% (P<0.01). The sensitivity and specificity of CE -TCCS in diagnosing vertebral -basilar artery stenosis >50% were 92.5% and 90.6% (P<0.01); the sensitivity and specificity of CE-TCCS in diagnosing blocking were 91.7% and 94.3% (P<0.01). The peak systolic velocity, end diastolicvelocity and mean flow rate of blood vessel in stenosis >50% group were significantly higher than those in stenosis <50% group (P<0.01), the pulsatility index had no significant difference between the two groups (P=0.368). Conclusion TCCS and CE-TCCS joint inspection can enhance the accuracy rate of diagnosis in vertebral-basilar artery stenosis occlusion lesions, and can be used in routine screening for patients with central vestibular vertigo.
KEYWORDS: transcranial color-coded sonography; contrast-enhanced transcranial color-coded sonography; vertebrobasilar artery; central vestibular vertigo
 
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