Cerebral vessel stenosis in sickle cell disease: criteria for detection by transcranial Doppler.
Cerebral vessel stenosis in sickle cell disease: criteria for detection by transcranial Doppler.
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镰状细胞病脑血管狭窄：经颅多普勒检测标准。
DOI：
10.1097/00043426-199023000-00005
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发表时间：
1990
期刊：
影响因子：
--
通讯作者：
Figueroa,R
中科院分区：
文献类型：
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作者：
Adams,RJ;Nichols3rd,FT;Aaslid,R;McKie,VC;McKie,K;Carl,E;Stephens,S;Thompson,WO;Milner,P;Figueroa,R
缺血性卒中是镰状细胞病（Hb SS）常见的致残并发症。大多数梗死发生于威利斯环大血管的颅内狭窄病变。经颅多普勒（Transcranial Doppler， TCD）通过测量这些动脉段的血流速度，可以根据血流速度升高来检测局灶性狭窄。我们报告了一项前瞻性研究的初步结果，该研究旨在制定基于TCD的狭窄病变检测标准，并识别有卒中风险的Hb SS患者。将6例血管造影显示病变的患者的TCD结果与115例无卒中的Hb SS儿童的TCD结果进行比较，我们得出结论：(a)大脑中动脉（MCA）、大脑前动脉（ACA）或颈内动脉（ICA）平均流速> ~ 190cm /s强烈提示局灶性狭窄；(b) MCA或ACA平均速度为150 ~ 190 cm/s提示异常，但目前不能视为狭窄的诊断；(c)平均流速高达150厘米/秒可能是由于低血细胞比容和/或年轻的影响，目前还不能与血管狭窄引起的流速升高区分开来。
Ischemic stroke is a common and disabling complication of sickle cell disease (Hb SS). Most infarctions occur in the presence of intracranial stenotic lesions of the large vessels of the circle of Willis. Transcranial Doppler (TCD), by measuring flow velocity in these arterial segments, can detect focal stenosis on the basis of elevated flow velocity. We report the preliminary results of a prospective study to develop criteria for detection of stenotic lesions based on TCD and identification of patients with Hb SS at risk for stroke. Comparing the TCD findings from six patients with lesions demonstrated by angiography to those from 115 Hb SS children without stroke, we conclude:(a) middle cerebral (MCA), anterior cerebral (ACA), or internal carotid (ICA) artery mean velocities> 190 cm/s strongly suggest focal stenosis;(b) MCA or ACA mean velocities of 150 to 190 cm/s suggest abnormality but at present cannot be considered diagnostic of stenosis;(c) mean velocities up to 150 cm/s are possibly due to the effects of low hematocrit and/or young age, and cannot as yet be distinguished from velocity elevations due to vessel stenosis.