Study On Abnormalities Of Peripheral Artery Structure And Function In Cerebral Infarction And Comparison Of TCCD And TCD In Intracranial Arteries Of Normal Subjects

ObjectivesThe objectives of this study are as follows: (1) To evaluate the value and correlation to brachial arterial Endothelium-dependent vascular diastolic function (EDD) and Intima-media thickness (IMT) of the carotid artery in middle-elder patients with cerebral infarction . (2) To compare the advantages, limitations, and reliability of velocity measurements with Transcranial Color-coded Duplexsonography (TCCD) versus Transcranial Doppler Sonography (TCD) in the major basal cerebral arteries of normal subjects, in order to provide more useful diagnostic information on the disease of intracranial vasculature.Methods and results1. Intima-media Thickness of Carotid Artery andEndothelium-dependent Vascular Diastolic Function of Brachial Artery in Middle -elder patients with Cerebral infarction Methods Thirty middle-elder patients with cerebral infarction and 63 healthy volunteers were employed for measuring the baseline inner diameters and diameters after reactive hyperemia of humeral artery. And IMT of carotid artery was also measured using high resolution ultrasound. Results The value of flow-mediated diameter (FMD) in cerebral infarction (CI) group was significantly lower than that in healthy(H) groups (P< 0.01). The value of CA IMT was significantly higher than that in H groups (P< 0.05) . A significant negative correlation between the CA IMT and FMD was found in all of the two groups .2. Comparison of TCCD and TCD in intracranial arteries of Normal SubjectsMethods A total of 80 healthy volunteers were employed for examining ACA,MCA,PCA via temporal acoustic window,examining VA and BA via foraminal windows. 72 of them were examined with TCCD and 58 were examined with TCD .50 subjects of them were involved in both TCCD and TCD within 24 hours. V_P , V_E ,V_M , PI , RI as well as S/D were determined in those cerebral arteries. Simultaneously,we recorded detection rate of respective basal cerebral arteries in both two methods. Corrected-angle of respective basal cerebral arteries and the length of blood stream were also measured by TCCD. Results: (1) Side-to-side blood flow Doppler parameters of all vessels were not significantly different in both TCCD and TCD(P >0.05). (2)TCCD can measure angle-corrected blood flow velocity, the corrected-angle of ACA is biggest and the corrected-angle of BA is the smallest in all vessels. Side-to-side corrected-angle of respective basal cerebral arteries were not significant different except VA. (3) In this study, the detection rate of VA is 100%in both two methods. For the rest basal cerebral arteries, the detection rate is small lower in TCCD than in TCD(P >0.05).(4) VP and VM of PCA,VA,BA, were higher in TCCD than in TCD(P <0.05),whereas blood flow Doppler parameters of MCA and V_P ,V_E, V_M of ACA were not significantly different(P >0.05).(5) The study presents normal reference value of TCD and TCCD.Conclusions1. A significant correlation between the EDD and carotid atherosc1erosis is found. The CI group showed severe EDD dysfunction in humeral artery and thickened CA IMT. The determinations on FMD and CA IMT have great significance for predicting and preventing cerebral infarction of middle-elder patients.2. (1) TCCD, in contrast to other examinations of cerebrovascular disease , is advantageous for nearby the bed to operate ,and the price is lower. It can provides the more accurate blood stream dynamics data for clinical diagnose and treatment . At present, measurements of flow velocity with TCCD is more valid than those obtained with TCD in ACA, PCA, VA and BA. The visualization of TCCD is better than TCD in diagnosing cerebravascular disease. (2)There was no significant difference in detection rate and wave-form between TCCD and TCD. We can monitor microemboli and hemodynamics of MCA with TCD , for there were no difference in the values of MCA between TCCD and TCD. furthermore,Equipment of TCD is smaller and it fix specified rheophore. (3) The range of flow velocities in basal cerebral arteries is wide in healthy people. the researchers who identify basal cerebral arterial stenosis or assessment compensatory circulation according to flow velocities should pay attention to it. If we diagnose cerebrovascular disorder base on side-by-side difference of flow velocities, the wave-form , PI and RI of cerebral artery ,clinical symptom and physical signshould be consider simultaneously.