川北医学院学报2026，Vol.41Issue(8)：938-942,5.DOI:10.3969/j.issn.1005-3697.2026.08.007
脑颈血管超声一体化检查在椎动脉颅内段闭塞与发育不良鉴别诊断中的应用及血流动力学特征分析
Diagnostic value and hemodynamic characteristics of combined cerebrovascular and cervical ultrasound in differentiating intracranial vertebral artery Occlusion from vertebral artery hypoplasia
摘要
Abstract
Objective:To investigate the diagnostic value of integrated brain and neck vascular ultrasound in differentiating occlusion of the intracranial segment of the vertebral artery(VA)from vertebral artery hypoplasia,and to analyze the differences in hemodynamic characteristics between the two conditions.Methods:A total of 54 patients with intracranial vertebral artery occlusion(occlusion group)and 48 patients with vertebral artery hypoplasia(hypoplasia group),all of whom underwent integrated carotid ultrasound and transcranial doppler(TCD)examination,were included.Carotid intima-media thickness(IMT)and plaque characteristics were measured.Peak systolic velocity(PSV),end-diastolic velocity(EDV),pulsatility index(PI),and resistance index(RI)were recorded at the intervertebral and intracranial segments of the vertebral artery,the middle cerebral artery,and the basilar artery,along with collateral circulation status.Binary Logistic regression analysis was used to identify independent differentiating factors,and receiver operating characteristic(ROC)curves were employed to evaluate the diagnostic performance of each parameter.Results:In the occlusion group,IMT,plaque detection rate,and the proportion of unstable plaques were all higher than those in the hypoplasia group(P<0.05).On the affected side,PSV and EDV of the vertebral artery at the intervertebral segment decreased,while RI increased.In the intracranial segment,PSV,EDV,and RI on the affected side were all lower,whereas PSV and EDV on the contralateral side were higher.PSV,EDV,and PI of the middle cerebral artery and basilar artery decreased,and the patency rate of the posterior communicating artery increased(P<0.05).Decreased intracranial PSV on the affected side,increased IMT,increased ΔRI on the affected side,and a patent posterior communicating artery were independent predictors of occlusion(P<0.05).The combined model achieved an AUC of 0.958(95%CI:0.923～0.993),with a sensitivity of 92.59%and a specificity of 89.58%,outperforming any single parameter(P<0.05).Conclusion:Intracranial VA occlusion and VA hypoplasia exhibit distinct hemodynamic profiles.Integrated brain and neck vascular ultrasound enables systematic evaluation of hemodynamic alterations throughout the extracranial and intracranial course of the VA,as well as other cervicocerebral vessels,demonstrating substantial clinical utility in the differential diagnosis of these two entities.关键词
椎动脉颅内段闭塞/椎动脉发育不良/脑颈血管超声一体化检查/血流动力学/鉴别诊断Key words
Intracranial vertebral artery occlusion/Vertebral artery hypoplasia/Integrated brain and neck vascular ultrasound/Hemodynamics/Differential diagnosis分类
医药卫生引用本文复制引用
江浩,魏米琳,石英娜..脑颈血管超声一体化检查在椎动脉颅内段闭塞与发育不良鉴别诊断中的应用及血流动力学特征分析[J].川北医学院学报,2026,41(8):938-942,5.基金项目
安徽省卫生健康科研项目(AHWJ2023BAa20151) （AHWJ2023BAa20151）
