用三维经颅多普勒(TCD)观查71例脑血管病患者脑底动脉的血流动力学变化。71例中脑出血10例,脑梗塞43例,短暂性脑缺血发作3例,动脉瘤2例,蛛网膜下腔出血2例,血管畸形8例,动脉炎3例。62例TCD异常(87.3％),其中脑出血10例均异常(10/10)、脑梗塞36/43,短暂性脑缺血发作3/3,其它14/15。TCD异常者中23例做了脑血管造影,20例证实了TCD的诊断,1例经手术证实为海绵状动脉瘤。结果提示TCD对脑血管疾病患者Willis环部位血流动力学异常的无损伤性诊断有较高的准确性和可靠性。 The hemodynamic changes of cerebral artery in 71 patients with cerebrovascular disease were observed by three-dimensional transcranial Doppler (TCD). 71 cases of midbrain hemorrhage in 10 cases, cerebral infarction in 43 cases, transient ischemic attack in 3 cases, 2 cases of aneurysm, 2 cases of subarachnoid hemorrhage, vascular malformation in 8 cases, 3 cases of arteritis. TCD was abnormal in 62 cases (87.3%), including 10 cases of intracerebral hemorrhage (10/10), cerebral infarction (36/43), transient ischemic attack (3/3) and other 14/15. TCD abnormalities in 23 cases of cerebral angiography, 20 confirmed the diagnosis of TCD, 1 case was confirmed as cavernous aneurysms. The results suggest that TCD has a high accuracy and reliability in the non-invasive diagnosis of Willis annulus hemodynamic abnormalities in patients with cerebrovascular disease.