| Objective To investigate the effect of neck rotation test on the spectrum form and parameters of the intervertebral(V2)and suboccipital vertebral artery(V3)and the diagnostic value of color Doppler ultrasound in rotational vertebral artery occlusion(RVAO).Methods A total of 180 patients came our hospital for carotid screening and without carotid and vertebral artery abnormalities were included.Doppler ultrasound was used to measure the blood flow spectrum parameters of the intervertebral(V2)and suboccipital(V3)vertebral artery before and after the neck rotation test.Patients were divided into a positive group(48 cases)and a negative group(132 cases)according to whether the reduction of vertebral artery spectrum PSV in the the intervertebral and suboccipital vertebral artery exceeded 20%,and the Doppler parameters of vertebral artery spectrum before and after the cervical transposition test were compared respectively between the positive group and the negative group.Results :(1)a total of 48 patients(26.7%),55 vertebral arteries with PSV decreasing more than 20% in the posterior cervical intervertebral space segment,defined as the positive group.11 patients,15 vertebral arteries in total were involved in the posterior cervical "low-speed unimodal" spectrum,and 4 of them involved bilateral vertebral arteries.The remaining 132 patients(73.3%)were defined as the negative group.(2)In the suboccipital segment,the positive group could be divided into the PSV increased group(25)and the PSV decreased group(28)according to the change of the PSV.Meanwhile,the abnormal spectrum of the vertebral artery flexion segment was mainly divided into "low-speed unimodal type"(8)and "high-speed unimodal type"(3).In addition,two patients(2 patients)were unable to detect the blood flow signal of suboccipital segment after detecting of RVAO.(3)Results of intervertebral vertebral artery: After neck transfer,PSV decreased from 56.84±13.17cm/s to36.19±16.17cm/s(P < 0.05),EDV decreased from 18.77±4.95cm/s to10.38±7.62cm/s(P<0.05),RI increased from 0.66±0.07 to 0.76±0.17(P<0.05),AND AT decreased from 39.73±14.07 ms to 33.00±12.00ms(P<0.05)in the positive group.The differences were statistically significant.There were no significant differences in PSV,EDV,RI and AT between anterior and posterior cervical rotation in negative group.(4)RM esults of the suboccipital vertebral artery: After neck rotation,PSV increased from 58.24±17.83cm/s to 87.65±27.20cm/s(P < 0.05),EDV increased from21.46±6.52 to 25.73±12.98cm/s(P<0.05),RI increased from 0.62±0.62 to 0.70±0.14(P<0.05),and the difference was statistically significant.There was no significant difference in AT from 40.32±11.00 ms to 36.50±16.45ms(P>0.05).PSV decreased from 63.77±18.27 to 39.96±12.43cm/s(P<0.05),EDV decreased from 22.45±6.52 to10.6±10.21cm/s(P<0.05),RI increased from 0.65±0.09 to 0.77±0.22(P<0.05),AT decreased from 42.56±10.07 ms to 33.60±14.51ms(P>0.05),and the differences were not statistically significant.There was no significant difference in PSV,EDV,RI,AT between anterior and posterior cervical rotation in negative group.(5)The incidence of vertigo after neck rotation in the positive group was 12.5%(6/48)higher than that in the negative group(6.1%,8/132),but the difference was not statistically significant(χ2= 3.588,P = 0.058).Conclusion: Neck rotation test can affect doppler spectrum of the intervertebral and suboccipital vertebral artery of some people.Among general population,RVAO patients without neurological symptoms account for a certain proportion.When RVAO is detected by ultrasound screening,the patient should be advised to avoid excessive neck rotation. |
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