南方医科大学学报

南方医科大学学报 ›› 2004, Vol. 24 ›› Issue (06): 685-688.

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应用经颅多普勒超声盗血指数评估脑动静脉畸形盗血的初步研究

吴钢1,3, 张小征2, 陆兵勋1, 许国英3, 郑依勇3   

  1. 1. 第一军医大学南方医院神经内科, 广东, 广州, 510515
    2. 广州军区武汉陆军总医院神经外科, 湖北, 武汉, 430070;
    3. 福建医科大学附属第一医院神经内科, 福建, 福州, 350005
  • 出版日期:2004-06-20 发布日期:2004-06-20
  • 基金资助:
    收稿日期:2003-9-25。
    作者简介:吴钢(1957- ),男,第一军医大学在读博士研究生.副主任医师、副教授,电话:0591-3344897.

Evaluation of steal phenomena by measuring the steal index using transcranial Doppler ultrasound in intracranial arteriovenous malformation

WU Gang1,3, ZHANG Xiao-zheng2, LU Bing-xun1, XU Guo-ying3, ZHENG Yi-yong3   

  1. 1. 第一军医大学南方医院神经内科, 广东, 广州, 510515
    2. 广州军区武汉陆军总医院神经外科, 湖北, 武汉, 430070;
    3. 福建医科大学附属第一医院神经内科, 福建, 福州, 350005
  • Online:2004-06-20 Published:2004-06-20

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摘要： 目的 作者曾推导出一侧颈动脉狭窄或闭塞时经颅多普勒超声(TCD)盗血指数(SI)计算公式,本研究介绍该指数在评价脑动脉畸形(AVM)中盗血现象的应用。方法 对16例经脑血管造影数字减影(DSA)证实的脑动脉畸形的TCD资料进行回顾性分析,以直接或间接供血动脉的平均血流速度(Vm供)与其相邻血管血流的平均血流速度(Vm邻)的比值Vm供/Vm邻和其相应血流的SI(SI=1-PI1/PI2,PI1为供血动脉的脉动指数,PI2为供血动脉相邻血管的脉动指数)值进行比较分析,并尝试比较SI与AVM大小的关系。结果 直接或间接供血动脉的Vm供/Vm邻均与SI值成正相关,相关系数分别为0.62、0.53,P值均小于0.05;此外,SI与血管畸形大小呈正相关趋势,r=0.48,但P>0.05,提示SI大小可能还与动静脉畸形的类型和血管发育程度有关。结论 根据TCD检测的SI值大小,结合DSA检测结果,可对AVM的大小、类型和血管床的发育情况进行分析判定。

Abstract: Objective The authors previously deduced a formula for calculating the steal index (SI) for evaluation of the steal phenomena during the development of the collateral circulation resulting from unilateral carotid artery occlusion or stenosis. In this study the authors examine the application of SI in evaluating the steal phenomena of cerebral blood flow in cases of in-tracranial arteriovenous malformation (AVM). Methods The clinical data of 16 cases of AVM confirmed by both digital sub-traction angiography (DSA) and transcranial Doppler (TCD) ultrasound were analyzed retrospectively. The ratio of the mean blood velocity in the direct or indirect feeding artery (Vmfv) for the area containing AVM to the mean blood velocity in the neighboring feeding artery (Vmna), Vmfv/Vmna, was compared with SI of the corresponding arteries (SI=1-PI1/PI2, where PI1 is the pulsatility index of the feeding artery and PI2 the pulsatility index of the neighboring feeding artery), and the correlation between SI and the size of AVM was analyzed statistically. Results The Vmfv/Vmna of direct and indirect feeding arteries for AVM both exhibited positive correlation with SI (r=0.62, P<0.05, n=16; r=0.53, P<0.01, n=27), and SI appeared to be in posi-tive correlation with the size of AVM, but which failed to be supported by statistical analysis (r=0.48, P>0.05, n=12). Conclusion The sizes, types and development of the vascular bed of AVM can be evaluatea by analysis of SI derived from TCD in combination with DSA.

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