颈脑一体化超声对颈内动脉颅内段狭窄或闭塞颅内外血流动力学特征分析OA

Objective:To analyze the hemodynamic characteristics of intracranial and extracranial blood flow in patients with intracranial internal carotid artery(IICA)stenosis or occlusion,and to explore the clinical value of integrated cervical cerebral ultrasound.Methods:Sixty patients with moderate to severe stenosis or occlusion of unilateral IICA admitted to the Second People's Hospital of Jingdezhen from January 2022 to August 2023 were selected,with the affected side as the study group and the healthy side as the control group.Integrated carotid brain ultrasound was used,which combines carotid artery ultrasound with transcranial color doppler ultrasound,to detect the diameter(D),peak systolic velocity(PSV),end diastolic velocity(EDV),resistance index(RI),and middle cerebral artery(MCA)PSV,EDV,and pulsatility index(PI)of the extracranial internal carotid artery(EICA).The differences were analysed in these parameters between the two groups,the ultrasound characteristics of the affected side EICA and MCA,and the diagnostic efficacy of carotid artery ultrasound and integrated carotid brain ultrasound for moderate to severe stenosis or occlusion in IICA.Results:The D,PSV,and EDV of EICA in the study group were lower than those in the control group,while RI was higher than that in the control group.The PSVand PI of MCA in the study group were lower than those in the control group,and the EDV of MCA in the study group was higher than that in the control group,the difference between the two groups was statistically significant(P<0.05).Using computed tomography angiography as the diagnostic criterion,the sensitivity,specificity,and accuracy of integrated cervical brain ultrasound in diagnosing IICA stenosis or occlusion were higher than those of carotid artery ultrasound,and the difference was statistically significant(P<0.05).The consistency test results showed that the consistency between carotid artery and CTA was moderate,while the consistency between integrated carotid brain ultrasound and CTA was high,with Kappa values of 0.533 and 0.833,respectively.The ROC curve indicated that the diagnostic efficiency of integrated cervical brain ultrasound was higher than that of carotid artery ultrasound,and the difference is statistically significant(P<0.05).Conclusion:When IICA stenosis or occlusion occurs,there are characteristic changes in the D,PSV,EDV,RI of the affected EICA,as well as the PSV,EDV,PI of the affected MCA.Cervical brain integrated ultrasound can objectively evaluate these characteristic changes and has high diagnostic efficacy.