Transcranial Doppler Ultrasound For The Diagnosis Of Posterior Circulation Ischemia

Objective Observed posterior circulation ischemia by transcranial Dopplerblood flow characteristics and spectral parameters change; evaluate the diagnosticvalue of the posterior circulation ischemia by transcranial Doppler ultrasound.Methods Continuous collection of Ningxia Medical University GeneralHospital, Department of Neurology, cardiovascular and cerebrovascular diseasefrom March2012to March2013in-patients, whether based on brain MRI findingsmay explain the clinical symptoms of PCI, the responsibility lesions and signs ofblood supply to the posterior circulation area, as well as inclusion and exclusioncriteria, the final choice of120cases of PCI patients as the experimental group,the same period in our hospital examination mood, history of cerebrovasculardisease and brain health in60cases as a control group. All enrolled subjects wereperformed transcranial Doppler ultrasound (TCD) examination, PCI group wereperformed CTA or MRA examination to check and make comparative analysis;while recording the patient’s age, blood pressure, blood glucose, lipids and othergeneral conditions. TCD detection experimental group, control group ofintracranial arteries, after recording bilateral posterior cerebral artery (PCA),bilateral vertebral artery (VA), basilar artery (BA) systolicvelocity (Vs),meanvelocity (Vm), diastolic velocity (Vd) and observe the spectrummorphological changes and artery pulsatility index (PI), the two sets of test resultsdo comparative analysis.Results (1) In the experimental group were detected in the blood vessel 600, which BA120, VA240, PCA240, TCD detected obliteration5, mild stenosis43,15moderate stenosis, severe stenosis2, where VA (38), BA (17), PCA (10);(2) The Subclavian steal syndrome (SSS)2cases, after three patients exist trafficartery open;(3) In the control group blood flow velocity as a reference:experimental group increased blood flow velocity123(123/600;20.5%),slowing blood flow velocity203(203/600;33.8℅), blood flow velocity anomalydetection rate of54.3℅(326/600);(4) Experimental group and the control groupstatistical comparisons of hemodynamic parameters: Bilateral PCA Vd values incomparison with the PI values were significantly different, RVA Vs value incomparison PI values were significantly different, LVA in PI values weresignificantly different contrast, BA Vs value in PI values were significantlydifferent contrast.(5) To the CTA as a reference: TCD after the diagnosis ofarterial lesions sensitivity, specificity, false-positive rate, false negative rate,positive predictive value, negative predictive value was62.71℅,95.58℅,4.42℅,37.29℅,78.72℅,90.76℅, Kappa value of0.63.(6) To the MRA as a reference:TCD after the diagnosis of arterial lesions sensitivity, specificity, false-positiverate, false negative rate, positive predictive value, negative predictive value was60.81℅,92.21℅,7.79℅,39.19℅,71.43℅,88.02℅, Kappa value of0.558.Conclusion TCD detection result is reliable and noninvasive, dynamicallyrepetition, simple, is the preferred method of clinical screening as PCI patients.