Hemodynamic detection of posterior cerebral artery dysplasia with transcranial Doppler ultrasonography / 中国脑血管病杂志

ABSTRACT

Objectives: To analyze the hemodynamic characteristics of dysplastic posterior cerebral artery with transcranial Doppler ultrasonography (TCD) and to investigate the diagnostic value of TCD. Methods: Fifty-two patients with posterior cerebral artery P1 segment (PCA-P1) dysplasia screened by MRA and TCD were selected. The hemodynamic changes before and after the carotid compression test were observed, and compared with 52 healthy subjects without abnormal blood vessels (control group). Results: Circled digit oneThe blood flow velocity of 52 patients with PCA-P1 dysplasia on the dysplasia was 55 ± 8 cm/s on the dysplastic side, which was significantly lower than that of 60 ± 6 cm/s in the control group (P < 0.01). After compressing the ipsilateral common carotid arteries (CCAs) respectively, the velocity of PCA-P1 on the dysplastic sides was 192 ± 25 cm/s, and it was significantly higher than 96 ± 14 cm/s in the control group (P < 0.01). The ratio of velocity in patients with dysplasia before and after the compression test (after Vp/before Vp) was 3.52 ± 0.53, and it was significantly higher than 1.60 ± 0.17 in the control group (P < 0.01). Circled digit twoAfter compressing the ipsilateral CCAs respectively, the end-diastolic flow velocity and the ratio before compression (after Vp/before Vp) was 4.48 ± 1.28, and it was significantly higher than 1.61 ± 0.25 in the control group (P < 0.01). Circled digit threePCA-P1 pulsatility index (PI) on the dysplastic sides was 1.00 ± 0.22, and it was significantly higher than 0.78 ± 0.09 in the control group (P < 0.01). There was significant difference (P < 0.01). Circled digit fourOf the 52 patients, the flow spectrum of 28 patients showed high-resistance changes and the flow spectrum of 24 patients was normal. Before and after compressing the ipsilateral CCAs, the ratio of high-resistance spectrum group compared to that before compressing (after Vd/before Vd) was 5.3 ± 1.1, and it was significantly higher than 3.5 ± 0.6 in normal blood flow spectrum group. There was significant difference (P < 0.01). However, there was no significant difference between after VP/before VP and the normal blood flow spectrum group. ©Dysplasia in PCA-P1 was suspected in 39 cases by TCD, and 32 of them were confirmed with MRA. The positive coincidence rate was 82.1%, 17 of them showed high-resistance flow spectrum, and 16 had dysplasia in PCA-P1 confirmed by MRA. The positive coincidence rate was 94.1%. Conclusion: TCD in combination with blood flow spectrum shape may initially diagnose the dysplasia in PCA-P1 according to the changes of hemodynamic parameters of PCA-P1 before and after the CCA compression test.