TCD/TCCD与DSA在评估颈动脉狭窄侧支开放中的互补关系研究

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关键词：经颅多普勒/经颅彩色多普勒；数字减影血管造影；颈内动脉重度狭窄或闭塞；侧支循环；互补关系 中图分类号：R543.4文献标志码：A文章编号：1001-5779（2025）07-0642-04 DOI：10. 3969/j. issn.1001-5779.2025.07.004

Thecomplementary relationship of TCD/TCCD and DSA in assessingcollateral openingincarotid arterystenosis

HUANGKai¹，LAI Li-ping²，GUO Ming-wei² （1.TheFirst Clinical Medical SchoolofGannan Medical University；DepartmentofNeurology，TheFistAffiliated Hospital ofGannan Medical University，Ganzhou，Jiangxi 341000）

Abstract：Objective：To explore theadvantages，disadvantagesand complementary relationship betweentranscranial doppler （TCD）/transcranial color doppler（TCCD）and digital subtraction angiography（DSA） in assessing collateral opening incasesof severe stenosisorocclusion of the internal carotidartery.Methods：TheDSAand TCD/TCCD examination reports of 63 patients with severe stenosis （ ⩾70% ）orocclusion of the internal carotid artery were analyzed. Using DSA asthe goldstandard，thesensitivityandaccuracyofTCD/CCD indetecting theopening oftheleptomeningeal anastomosis branch of theanterior communicating artery（ACoA），theposteriorcommunicating artery（PCoA），the soft meningealanastomotic branchesbetweenposteriorcerebral artery（PCA）and middle cerebral artery（MCA）were analyzed;andthediferencesbetween two testsfortheopeningof theophthalmicartery（OA）were analysed.Results ： The Kappa value for the consistency test between TCD/TCCD and DSA in detecting ACoA opening was 1（ P<0.001 ）； TCD/TCCDand DSA were consistentin detecting theopening of anteriorand posterior communicating arteries；for PCoA opening，the Kappa value wasO.888（ P<0.001 ）；forOAopening，itwasO.653（ P<0.001 ）；and for thesoft meningeal anastomotic branchesbetween PCA and MCA，the Kappa value was 0.777 （ P<0.05 ）. TCD/TCCD was more sensitive andefficientthan DSAindetecting OAopening，but significantly inferior toDSAindetecting theopeningof thesoft meningeal anastomotic branches.Conclusion： In cases of severe stenosis or occlusion of the internal carotid artery， TCD/TCCD can assist DSA in evaluating collateral opening and has the potential for wider application.

KeyWords：Transcranial doppler/transcranialcolor-coded duplex sonography；Digitalsubtractionangiography；Severe stenosis orocclusion of the internal carotid artery；Collateral circulation；Complementary relationship

颈内动脉重度狭窄或闭塞在脑血管疾病中占比较大，决定其临床表现和预后的因素除了血管狭窄病变部位、程度和进展速度外，侧支循环开放与否以及代偿程度也是至关重要的。（剩余6757字）