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目的探讨经颅多普勒对分水岭脑梗死的临床使用价值。方法所有病例均行头MRI、TCD以及主动脉弓、全脑血管造影(DSA)检查,并证实为分水岭脑梗死。结果一侧颈内动脉系统狭窄或闭塞的10例患者中TCD示6例患侧ACA1血流方向逆转,4例患侧OA血流方向逆转,7例健侧ACA1血流速度高于患侧,6例患侧PCA血流速度增快;14例大脑中动脉主干或上干狭窄或闭塞的患者中TCD示6例大脑中动脉阶段性高流速,6例大脑中动脉未探及血流,2例大脑中动脉低流速伴高PI;1例一侧颈内动脉系统轻度狭窄的患者TCD无明显的变化。结论经颅多普勒能够有效地评价分水岭脑梗死患者脑血管狭窄和侧枝循环的代偿情况。
Objective To investigate the clinical value of transcranial Doppler imaging in watershed cerebral infarction. Methods All patients underwent MRI, TCD, aortic arch and whole brain angiography (DSA) and confirmed as watershed cerebral infarction. Results In 10 patients with stenosis or occlusion of one side of internal carotid artery, TCD showed reversal of blood flow in 6 cases of ACA1, reversal of 4 cases of OA blood flow, and 7 cases of ACA1 blood flow velocity higher than the ipsilateral, In 6 patients with PCA, the blood flow velocity increased rapidly. Among the 14 patients with middle cerebral artery trunk or stenosis or occlusion, TCD showed 6 cases of moderate middle cerebral artery flow, 6 cases of middle cerebral artery without blood flow and 2 The lower middle cerebral artery flow velocity was associated with high PI. There was no significant change in TCD in one patient with mild stenosis of internal carotid artery. Conclusion Transcranial Doppler can effectively evaluate the compensation of cerebrovascular stenosis and collateral circulation in patients with watershed cerebral infarction.