TCD상의 기저동맥혈류속도와 교뇌경색크기와의 연관성

Abstract

Background : The clinical significance of abnormal flow velocity(FV) in the posterior circulation on transcranial doppler(TCD) and its association with infarct size, remains unclear. Methods : Between July 1996 and April 2001, of 1,477 stroke patients included in the Seoul National University Hospital TCD registry, sixty consecutive patients with pontine infarct(PI), who underwent both TCD and MRI within 30 days of onset were recruited. The patients were divided into 3 groups according to the value of mean FV of basilar artery(BAFV): Group I(n = 15, BAFV≤24 cm/s); Group II(n = 32, normal BAFV); Group III(n = 13, BAFV≥61 cm/s). We reviewed all MRIs and MR angiographies and assessed the infarct size, the presence of significant vascular stenosis(> 50%) of BA and abnormalities of vertebral artery(VA). An infarct size was measured on the T2-weighted axial images with a computerized-image analysis. Pontine infarcts were also classified according to the morphology as PI extending to the basal surface(BPI) and deep PI without extension to the basal surface(DPI). Results : Median infarct size in Group I(0.79 cm2, p=0.09) and III(1.36 cm2, p=0.07) tended to be larger than that of Group II(0.65 cm2). The statistical significance was present when Group I and III were merged into one “abnormal BAFV” group(p = 0.03). Significant stenosis of the BA was more frequent in Group III than group II p = 0.04) while VA abnormality was relatively frequent in Group I as compared to Group II(p = 0.08). Conclusion : “Abnormal BAFV” on TCD is associated with large-size PI. Abnormal underlying vessels seem to be responsible for the abnormal TCD findings. Korean Journal of Stroke 2002;4(2):99~104