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目的探讨经颅多普勒超声(TCD)对烟雾病患者行脑硬脑膜动脉血管融通术(EDAS)前后颞浅动脉血流变化的评估价值。方法对2010年2月至2010年6月收治的45例烟雾病患者行EDAS前后进行TCD检查,检测手术前后患者颞浅动脉的频谱形态及各项血流参数的变化,并与其DSA结果进行比较。结果 TCD检测示术前患者的颞浅动脉呈典型颅外动脉频谱,频窗清晰;术后频谱明显颅内动脉化,血流速度明显增加,血供增加。手术前后患者颞浅动脉的平均流速分别为(24.96±8.96)cm/s和(40.33±16.57)cm/s,手术前后搏动指数分别为(2.06±0.69)和(1.44±0.69),手术前后均差异显著(P<0.05)。术后复查DSA显示,血管重建良好25例,中等16例,差4例;TCD复查示良好21例,中等18例,差6例,与DSA比较总符合率为82.22%(37/45)。结论 TCD能够准确检测烟雾病患者行EDAS前后颞浅动脉血流动力学的变化,可为其手术疗效的评估提供一定的客观依据;因其具有简便、快速、无创、经济、可重复、可动态检测的特点,对定期随访观察病程发展更具有优越性。
Objective To investigate the value of transcranial Doppler ultrasonography (TCD) in detecting changes of superficial temporal artery blood flow in patients with moyamoya disease before and after brain dura arteriovenous arterial infusion (EDAS). Methods TCD was performed before and after EDAS in 45 patients with moyamoya oncology from February 2010 to June 2010 to detect the changes of the superficial temporal artery spectrum and the various blood flow parameters before and after the operation and to compare with the results of DSA . Results TCD showed that the superficial temporal artery showed a typical extracranial arterial spectrum with a clear frequency window. The postoperative spectrum was obviously intracranial arterialization, the blood flow velocity increased obviously and blood supply increased. The mean velocity of superficial temporal artery in patients before and after surgery was (24.96 ± 8.96) cm / s and (40.33 ± 16.57) cm / s, respectively. The pulsatility index before and after operation were 2.06 ± 0.69 and 1.44 ± 0.69 respectively The difference was significant (P <0.05). Postoperative DSA showed good revascularization in 25 cases, moderate 16 cases and poor 4 cases. TCD showed good in 21 cases, moderate in 18 cases and poor in 6 cases. The total coincidence rate with DSA was 82.22% (37/45). Conclusions TCD can accurately detect the changes of hemodynamics of the superficial temporal artery before and after EDAS in patients with moyamoya disease, which can provide some objective evidence for the evaluation of its curative effect. Because of its simple, rapid, noninvasive, economical, reproducible and dynamic Detection of the characteristics of regular follow-up to observe the course of development has more advantages.