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观察经颅多谱勒超声（ＴＣＤ）对颈部和颅内血管狭窄诊断的可靠性。方法收集患者１１０例，分为非脑血管病（１５例）、非闭塞性脑血管病（１８例）、闭塞性脑血管病（７７例）三组。分别用２Ｈｚ和４Ｈｚ多谱勒探头检查颅脑和颈部大动脉的血流速度，然后做数字减影血管造影（ＤＳＡ）。结果在闭塞性脑血管病组共检查血管７７１条，多谱勒超声发现狭窄血管１２４条，６４７条正常，其中１１３条与ＤＳＡ所见一致，ＤＳＡ发现另外１８条狭窄的血管。统计结果显示，ＴＣＤ诊断血管狭窄的敏感性是８６％，特异性达９８％，假阳性是８％，假阴性是３％。ＴＣＤ漏诊和误诊的血管狭窄，在颅内、颅外分布无显著差异。在非脑血管病组和非闭塞性脑血管病组的３３人中，ＴＣＤ无１例误诊为狭窄。结论ＴＣＤ对诊断颅内和颈部严重狭窄血管具有较高的特异性和敏感性。对大脑中动脉、颈内动脉近端和远端，以及锁骨下动脉狭窄诊断的可靠性较高。不易与其他疾病相混淆，可作为ＤＳＡ检查的筛选手段。
To evaluate the reliability of transcranial Doppler sonography (TCD) in the diagnosis of cervical and intracranial vascular stenosis. Methods One hundred and ten patients were collected and divided into three groups: non-cerebrovascular disease (15 cases), non-occlusive cerebrovascular disease (18 cases) and occlusive cerebrovascular disease (77 cases). Blood flow velocities of the brain and the neck artery were examined with 2 Hz and 4 Hz Doppler probes, respectively, and then digital subtraction angiography (DSA) was performed. Results A total of 771 blood vessels were examined in the occlusive cerebrovascular disease group. 124 stenotic vessels were found by Doppler ultrasound, and 647 were normal. Among them, 113 were consistent with DSA findings and another 18 were stenosed by DSA. The statistical results show that the diagnostic sensitivity of TCD for vascular stenosis is 86%, the specificity is 98%, the false positive is 8% and the false negative is 3%. TCD missed diagnosis and misdiagnosis of vascular stenosis, intracranial, extracranial distribution no significant difference. Among 33 non-cerebrovascular disease patients and non-occlusive cerebrovascular disease patients, none of TCD was misdiagnosed as stenosis. Conclusion TCD has high specificity and sensitivity for the diagnosis of severe stenosis of the brain and neck. The middle and distal cerebral arteries, carotid artery proximal and distal, as well as the reliability of the diagnosis of subclavian artery stenosis. Not easy to be confused with other diseases, DSA screening can be used as a screening tool.