Analysis of the hemodynamics changes of ipsilateral extracranial carotid artery with middle cerebral artery stenosis or occlusion patients

摘要

Objective: By observing the relation between middle cerebral artery stenosis or occlusion patients with ipsilateral extracranial carotid artery hemodynamics changes, to identify the value of hemodynamic change of extracranial carotid artery in predicting the middle cerebral artery stenosis, in order to improve the detection rate and accuracy. Methods: Eighty-three patients with unilateral severe middle cerebral artery stenosis or occlusion who confirmed by MRA were enrolled in the study, in all case were detected by TCD. The relationship of hemodynamic between extracranial carotid arteries and intracranial carotid arteries were analyzed. Results:The patients with severe middle cerebral artery stenosis or occlusion tend to have lower velocity and higher pulsitility index (PI). The PI(iCA), Vm(iCA) has a certain significance. The PI difference of carotid artery, end diastolic velocity of internal carotial artery (Vd (iCA) ) can evaluate stenosis of MCA more sensitive. The PI difference of common carotid artery=0.13, PI difference of internal carotid artery=0.15, Vd (iCA) =13.8 cm/s, Yonden index were 0.709, 0.710, 0.601.Sensitivity were 80.49％, 78.05％, 80.49％.Specificity were 90.48％, 92.86％, 78.57％;Positive predictive value were 89.20％, 91.42％, 78.57％.Negative predictive value were 82.60％, 81.25％, 80.48％. Conclusion: The patients tend to have lower velocity and higher PI. The PI difference of carotid artery, Vd(iCA), PI(iCA), Vm (iCA) severe middle cerebral artery stenosis or occlusion can be evaluated and provide a basis for the early diagnosis.