Intracranial Collateral Flow Estimated by Color Velocity Imaging Quantification Ultrasound: A Protector of Recurrent Stroke in Patient with Carotid Stenosis?
Intracranial Collateral Flow Estimated by Color Velocity Imaging Quantification Ultrasound: A Protector of Recurrent Stroke in Patient with Carotid Stenosis?
复制标题
通过彩色速度成像量化超声估计颅内侧支血流：颈动脉狭窄患者复发性中风的保护者？
DOI：
10.2174/1567202613666160817092521
复制
发表时间：
2016-10
影响因子：
2.1
通讯作者：
Ho Stella Sin Yee
中科院分区：
文献类型：
--
作者：
Fang Hui;Chen Xiang Yan;Song Bo;Cheng Bo;Xu Yu Ming;Wong Ka Sing;Ho Stella Sin Yee
有颈动脉疾病的中风患者疾病复发的风险很高。应用颅外双功技术测量脑血流量(BFV)，用于临床评估颅内侧支，探讨颈动脉病变卒中患者颅内侧支的存在与卒中复发的关系。研究对象为三年间在本院接受颈动脉双功能超声检查的连续卒中患者。颈动脉狭窄诊断为≥50%狭窄，用彩色速度成像定量超声软件测量颅外动脉血流速度。以颈总动脉血流量为≥370m L/m in，椎动脉血流量为≥120m L/m in为颅内侧支循环血流量。进行单变量和多变量分析，以确定复发卒中的独立预测因素。112例(19.1%)≤颈动脉狭窄50%的患者来自连续的缺血性卒中患者。在平均28.6±13.1个月的随访期内，32例(28.6%)患者发生了卒中复发。根据脑动静脉血流量估算，有颅内侧支循环血流量的患者卒中再发率低于无侧支循环血流量患者(9.5%比33%，P=0.032)。在调整了潜在的混杂因素后，CVIQ估计的颅内侧支循环是复发卒中的独立保护者(OR，0.169；95%CI，0.034-0.842；P=0.03)。结论：CVIQ技术估计的颅内侧支循环血供对颈动脉狭窄的卒中患者有保护作用，可预防卒中复发。
Stroke patients with carotid disease have a high risk of recurrence of disease. By measuring cerebral blood flow volume (BFV) using extracranial duplex technique for clinical estimation of intracranial collaterals, we aimed to investigate the relationship between the presence of intracranial collaterals and stroke recurrence in stroke patients with carotid disease. Consecutive stroke patients indicated for carotid duplex ultrasound investigations in our hospital were recruited during three years' period. Carotid stenosis was diagnosed as ≥50% stenosis and extracranial arterial BFV was measured by using color velocity imaging quantification ultrasound (CVIQ) software. Presence of intracranial collateral flow was defined as a blood flow volume of either ≥370 mL/min in common carotid artery or ≥120 mL/min in vertebral artery. Univariate and multivariate analyses were performed to determine the independent predictors of recurrent stroke. One hundred and twelve stroke patients (19.1%) with ≤50% carotid stenosis were recruited from consecutive ischemic stroke patients. During a mean follow-up of 28.6±13.1 months, recurrent stroke was recorded in 32 (28.6%) out of the total recruited patients. Estimated by blood flow volume measured by CVIQ, the patients with intracranial collateral flow had a lower rate of recurrent stroke than those without (9.5% vs. 33%, P=0.032). After adjusting for potential confounders, the presence of CVIQ-estimated intracranial collateral flow was an independent protector of recurrent stroke (OR, 0.169; 95% CI, 0.034- 0.842; P=0.03). It could be concluded that blood supply through intracranial collateral flow estimated by CVIQ technique may protect stroke patients with carotid stenosis from suffering recurrent stroke.