Application Value Analysis Of Color Doppler Ultrasound Combined With Transcranial Doppler In Measuring Vertigo Due To Vertebral Artery Insufficiency

Objective: To measure the vascular disease and hemodynamics of patients with vertebral artery insufficiency blood supply through color Doppler ultrasound combined with transcranial Doppler,to improve the understanding of vertebral artery insufficiency,and to determine the effective rate of diagnosis,so as to be clinical The development of a new diagnostic method for vertigo due to vertebral artery insufficiency provides theoretical basis and reference value.Methods: A total of 120 patients with vertebrobasilar artery insufficiency(VBI)vertigo diagnosed by digital subtraction angiography(DSA)who visited Department of Neurology of Yidu Central Hospital from December 2018 to March 2021 were selected as the observation group,and 120 healthy persons who underwent physical examination during the same period were selected as the control group.Use transcranial Doppler to detect the information of intracranial arteries,and detect the blood flow spectrum of bilateral anterior cerebral artery(ACA),middle cerebral artery(MCA),basilar artery(BA)and intracranial segment of vertebral artery(VAi)respectively Signal,record the blood flow direction,peak systolic flow velocity,end-diastolic flow velocity and spectral shape information under the condition of clear spectrum shape and stable signal;color Doppler ultrasound is used for common carotid artery,internal artery,external artery and vertebral artery Segment and cervical segment are detected sequentially.Observe the anatomical structure and direction of the blood vessel on the Doppler ultrasound image,observe the intima,whether there are hardened plaques and the thickness of the intima-media,etc.,and on the best image Measure the inner diameter of the blood vessel;observe the blood flow direction of the entire vascular cavity,blood flow filling,stenosis,obstruction,deformation,etc.,adjust the width of the pulse Doppler sampling frame,and measure the hemodynamic parameters.Result:(1)120 patients with vertebral artery insufficiency vertigo were tested with CDFI combined with TCD and DSA.The results showed that the detection rate of CDFI alone was 80.6%,the sensitivity was 82.6%,the specificity was 84.7%,and TCD alone was used.The detection rate was 83.4%,the sensitivity was 84.9%,and the specificity was82.7%.The detection rate of CDFI combined with TCD was 95.6%,the sensitivity was94.3%,and the specificity was 95.4%.(2)Comparison of vascular stenosis rate: There were 40 cases of vascular stenosis in the observation group,including 10 cases of intracranial anterior circulation stenosis,accounting for 8.3%,extracranial internal carotid artery stenosis in 14 cases,accounting for 11.7%,and vertebrobasilar artery stenosis in 16 cases,accounting for 8.3% 13.3%;In the control group,there were 1 cases of intracranial anterior circulation stenosis and extracranial internal carotid artery stenosis,accounting for 0.83%.There was a statistical difference in the rate of arterial vascular stenosis between the two groups,P<0.05.(3)When the internal carotid artery system is in mild stenosis,the blood flow velocity of the vertebrobasilar and vertebral arteries is not statistically different from the average flow velocity,P>0.05.When the internal carotid artery system is in moderate to severe stenosis,the vertebrobasilar and bilateral vertebral arteries The blood flow changes significantly,and the peak blood flow velocity during systole is significantly increased,with a statistical difference,P<0.05;when there is stenosis on one side of the vertebral artery,the blood flow at the distal end of the vertebral artery stenosis decreases,and the blood flow of the contralateral vertebral artery appears Compensatory increase,no significant difference between vertebrobasilar blood flow and average flow velocity,P>0.05.(4)Analysis of the inner diameter of the vertebral artery in the two groups showed that the left vertebral artery was significantly higher than that of the right vertebral artery,the difference was statistically significant,P<0.05,there was no statistical difference in the inner diameter difference between the two groups,P>0.05;calculated vertebral artery The result of asymmetry rate showed that the asymmetry rate of vertebral artery in the observation group was significantly higher than that in the control group,the difference was statistically significant,P<0.05.(5)Comparison of vertebral artery hemodynamics of vertebral artery dysplasia showed that the blood flow of the affected side of the two groups of patients was significantly lower than that of the healthy side.The difference was statistically significant,while the bilateral vertebral artery resistance index(RI)was not significantly different.P>0.05.There are significant differences in the vertebral artery to basilar artery blood flow velocity ratio(VA/BA FVR)between the two groups,the affected side is lower than the uninfected side,and the difference is statistically significant;the asymmetry index reflects the difference in blood flow between the vertebral arteries on both sides.The group was significantly higher than the control group,the difference was statistically significant(P<0.05).(6)Analyzing the influence of abnormal vertebral artery movement on the vertebral artery blood flow velocity,the results of the study showed that the patient’s vertebral artery penetration was abnormal,and there was no significant difference between the vertebral artery blood flow velocity and the average velocity,P>0.05;abnormal vertebral artery movement <90 degrees(Severe degree of curvature),the blood flow speed of the vertebral artery is significantly lower than the average speed,when the vertebral artery is abnormally >90 degrees(the degree of curvature is lighter),there is no significant difference between the blood flow speed of the vertebral artery and the average speed.(7)Comparison of the results of ultrasound detection of VBI patients and DSA: The results of the study show that the results of CDFI combined with TCD in the detection of vertebral artery stenosis,abnormal walking shape,and dysplasia in VBI patients have obvious consistency.Conclusion:(1)CDFI combined with TCD to detect vertebral artery insufficiency can effectively reflect the results of vertebral artery and carotid artery stenosis,abnormal walking,and vascular disease,and it is generally consistent with the DSA results;(2)Vertigo due to insufficient blood supply of the vertebrobasilar artery may be closely related to vertebrobasilar artery disease and internal carotid artery stenosis(especially bilateral arterial stenosis);(3)When vertebral artery dysplasia occurs,the contralateral vertebral artery will often compensatory increase the blood flow velocity.When the contralateral side is not fully compensated,it may induce the appearance of vertebral basilar artery insufficiency and dizziness.