脑静脉窦血栓形成患者的颈内静脉血流动力学超声研究

摘要

目的探讨脑静脉窦血栓形成（cerebral venous sinus thrombosis，CVST）患者的颈内静脉（internal jugular vein，IJV）血流动力学超声改变。　　方法经磁共振静脉造影（magnetic resonance venography，MRV）和（或）脑血管造影（digital subtraction angiography，DSA）诊断CVST患者48例，分别行双侧颈内静脉超声检查，检查内容包括多发CVST患者双侧颈内静脉内径及平均流速，单纯上矢状窦或直窦CVST患者各项结果双侧平均值，计算血流量，并选取正常对照组28例，各项检查结果行统计学对比分析。　　结果多发CVST组患侧吸气相及呼气相颈内静脉内径无显著变化（P=0.398），多发CVST组健侧、上矢状窦或直窦CVST组双侧及健康对照组双侧颈内静脉内径吸气时增宽，呼气时变窄，差异有显著性；多发CVST组患侧颈内静脉内径较多发CVST组健侧（P=0.009）、上矢状窦或直窦CVST组（P=0.02）及对照组（P=0.006）颈内静脉内径变窄，差异有显著性。多发CVST组患侧颈内静脉横截面积小于多发CVST健侧（P=0.006）、上矢状窦或直窦CVST组（P=0.005）及对照组（P=0.001）；颈内静脉平均流速低于多发CVST健侧（P=0.015）、上矢状窦或直窦CVST组（P=0.019）及对照组（P=0.011）；颈内静脉的血流量也低于多发CVST健侧（P=0.011）、上矢状窦或直窦CVST组（P=0.028）及对照组（P=0.008），差异具有显著性。　　结论多发CVST患者患侧颈内静脉内径随呼吸相无明显变化，且患侧颈内静脉血流量减低。%Objective To analyze the hemodynamics of internal jugular vein (IJA) by ultrasound in patients with cerebral venous sinus thrombosis (CVST). Methods A total of 48 patients with CVST diagnosed by magnetic resonance venography (MRV) or digital subtraction angiography (DSA) underwent bilateral IJV ultrasound examination, including the diameters and average velocity of contralateral and ipsilateral IJV of multiple CVST and average results of bilateral IJV for superior sagittal sinus or straight sinus CVST. Bilateral blood flow of IJV was calculated. Twenty-eight cases of normal control group were selected. The test results were statistically analyzed. Results Ipsilateral IJV diameter of multiple CVST did not change signiifcantly with the respiratory phase (P=0.398). IJV diameters in the inspiratory phase were signiifcantly larger than those in the expiratory phase of multiple CVST contralateral side, superior sagittal sinus or straight sinus CVST group and normal control group. Ipsilateral IJV diameters of multiple CVST was significantly smaller than the contralateral side (P=0.009), superior sagittal sinus or straight sinus CVST group (P=0.02)and normal control group(P=0.006). Ipsilateral IJV cross-sectional area of multiple CVST was smaller than the contralateral side (P=0.006), superior sagittal sinus or straight sinus CVST group (P=0.005) and normal control group (P=0.001). Ipsilateral IJV blood lfow velocity of multiple CVST was lower than the contralateral side (P=0.015), superior sagittal sinus or straight sinus CVST group (P=0.019) and normal control group (P=0.011). Ipsilateral IJV blood lfow of multiple CVST was lower than the contralateral side (P=0.011), superior sagittal sinus or straight sinus CVST group (P=0.028) and normal control group (P=0.008). Conclusion Ipsilateral IJV diameter of multiple CVST does not change significantly with the respiratory phase. Ipsilateral IJV blood lfow of multiple CVST is reduced.