椎动脉超声联合磁共振血管成像对后循环缺血的诊断价值万金萍李宏建夏斐江苏省淮安市淮安医院超声科江苏淮安223200【摘要】目的探讨椎动脉彩色多普勒血流成像(CDFI)联合磁共振血管成像(MRA)对后循环缺血(PCI)的预测价值.方法用彩色多普勒血流成像(CDFI)对128例PCI的患者和56例非PCI的患者椎动脉颅外段形态，结构和血流动力学参数进行分析，同时进行磁共振血管成像(MRA),观察椎动脉全程血管的形态、结构,分析比较椎动脉超声联合MRA对PCI的预测价值.结果椎动脉CDFI检查发现椎动脉管径或血流异常121例，其中PCI组103例，非PCI组18例,MRA检查发现椎动脉异常98例，其中PCI组83例，非PCI组15例;CDFI联合MRA较单独CDFI和MRA检查预测PCI的灵敏度、阳性预测值、阴性预测值和诊断符合率均升高，特异度降低.结论CDFI联合MRA检查可了解全程椎动脉的走行及供血情况，不仅减少了PCI的漏诊率，而且能准确、可靠地检出椎动脉病变的部位、程度,为临床进行干预性治疗提供依据.【关键词】椎动脉；超声检查；磁共振检查；后循环缺血ApplicationofColorDopplerFlowImageCombinedwithMagneticResonanceAngiographyinPredictionofPosteriorCirculationlschemicWanJinping,LiHongjian,XiaFei(DepartmentofUltrasonography,HuaianhospitalinHuaian,223200)【Abstract】Object:Toexplorethepredicitiveroleofcolordopplerflowimage(CDFI)combinedwithmagneticresonanceangiography(MRA)inposteriorcirGculationischemic.Methods:CDFIwasappliedin128casesofPCIpatientsand56nonPCIpatients,extracranialvertebralarterymorphology,structureandheGmodynamicparameterswereanalyzed.Atthesametime,MRAwasappliedtoobservethemorphology,structureofthewholevertebralartery.AnalysisandcomparethepredicitiveroleofCDFIcombinedwithMRAinPCIpatients.Results:VertebralarteryCDFlexaminationshowedthatvertebralarterydiameterorhemodynamicparameterswereabnormalin121patients,amongthem,103caseswerePCI,18caseswerenonPCI.MRAexaminationshowedthatthevertebralarterywereabnomalin98patients,amongthem,83caseswerePCI,15caseswerenonPCI.CDFIcombinedwithMRAhashighersensitivity,positivepredictivevalue、negativepredictivevalueanddiagnosticaccordanceratetopredictPCIthanCDFIandMRAexaminationalone.andthespecificitywasdecreased.ConcluGsion:CDFIcombinedwithMRAcanobservethecourseandbloodsupplyofthewholevertebralartery,whichnotonlyreducedthemisdiagnosisrateofPCI,butalsodetectevertebralarterylesionaccuratelyandreliably,whichprovidethebasisforclinicaltreatmentandintervention.[Keywords]CDFI;MRA;Vertebralartery;PCI【中图分类号】R730.4【文献标识码】B【文章编号】1008—6315(2015)12—0233—02后循环又称椎基底动脉系统，由椎动脉、基底动脉和大脑后动脉组成，主要供血给脑干、小脑、丘脑、枕叶、部分颞叶及上段脊髓.临床上，后循环缺血性(posteriorcirculationischemic,PCI)是常见的脑缺血性疾病，约占脑血管疾病的20%左相1].椎动脉磁共振血管成像(magneticresonanceangiography,MRA)及椎动脉彩色多普勒血流显像(colordopplerflowimage,CDFI)对明确PCI的病因具有S要的价值,且两者具有优势互补的作用.本文总结了128例PCI患者和56例非PCI的患者，旨在探讨椎动脉CDFI,MRA以及二者联合在PCI中的诊断价值.1资料和方法1.1研究对象随机抽取在我院接受MRA和超声检查的疑椎动脉患者，其中PCI组患者128例,其中男78例，女50例，年龄45-75岁，平均年龄56.3岁.非PCI组56例,其中男78例，女50例，年龄43-68岁，平均年龄54.2岁.纳入标准:患者出现头晕/眩晕、肢体无力、头痛、呕吐、复视、短暂意识丧失、视觉障碍或行走不稳或跌倒，所冇患者均为首次发病.排除脑部肿瘤、出血性脑血管病、颈动脉疾病的患者.1.2仪器和方法超声诊断仪为GELogiq6或IU22，探头频率8〜14MHz,分别对入选患者行椎动脉彩色多普勒检査.患者于检査前24h停用血管活性药物.检查吋患者先取仰卧位,枕头垫于颈后，头稍后仰....
