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背景:眩晕患者中椎动脉狭窄性眩晕占相当比例,其诊断方法没有统一的标准,影响其诊断的准确性。用转颈、屈颈、头后仰法试验,简单的检查做到对椎动脉狭窄患者临床初诊,再进行经颅多普勒(TCD)和核磁共振血管成像(MRA)检查,可提高临床诊断准确率。目的:评估转颈屈颈及仰头试验与TCD和MRA检查对椎动脉狭窄性眩晕诊断价值。设计:以患者为研究对象,病例分析。单位:内蒙古医学院附属医院神经科。对象:2004-02/04内蒙古医学院附属医院神经科门诊眩晕的患者41例,排除非椎动脉狭窄的其他病因所致的眩晕。方法:用转颈、屈颈及头后仰法诱发出眩晕症状的41例患者,然后用TCD和MRA分别进行椎动脉和基底动脉检查。主要观察指标:41例患者三项检查结果。结果:41例患者经转颈试验屈颈和头后仰诱发眩晕症状,其中左右转颈出现眩晕者32例,检出率为78%,屈颈和头后仰出现眩晕者25例,检出率为61%。TCD检查发现双侧椎动脉血流不对称,双侧椎动脉直径相差在0.5～2.0mm者30例,检出率为73%。MRA检查发现血管内径双侧椎动脉不对称,相差在0.5～2.6mm者39例,其余2例患者双侧椎动脉狭窄,检出率为95%。结论:转颈、屈颈和头向后仰试验,对诱发患者出现眩晕症状,是否为椎动脉狭窄性眩晕进行确诊,TCD检查对诊断椎动脉狭窄的准确率相对较高,MRA检查确定椎动脉狭窄的准确率最高。
Background: vertigo vertebral artery vertigo accounts for a considerable proportion of vertigo in patients with vertigo, the diagnostic methods there is no uniform standard, affecting the accuracy of its diagnosis. With cervical rotation, cervical kyphosis, head back method test, a simple examination of patients with vertebral artery stenosis in clinical examination, and then transcranial Doppler (TCD) and magnetic resonance imaging (MRA) examination, can improve the clinical diagnosis Accuracy. OBJECTIVE: To evaluate the diagnostic value of cervical neck flexion and head-up test and TCD and MRA in the diagnosis of vertebral artery stenosis vertigo. Design: The patient as the research object, case analysis. SETTING: Department of Neurology, Affiliated Hospital of Inner Mongolia Medical College. PARTICIPANTS: 41 patients with vertigo from Department of Neurology, Affiliated Hospital of Inner Mongolia Medical College from February to April 2004, excluding vertigo caused by other causes of non-vertebral artery stenosis. METHODS: Twenty-one patients with dizziness were induced by revolving neck, flexing neck and head-back method. The vertebral artery and basilar artery were examined with TCD and MRA respectively. MAIN OUTCOME MEASURES: The results of the three tests in 41 patients. Results: Thirty-one cases of vertigo were induced by cervical neck flexion and head-back in 41 patients. Among them, 32 cases of vertigo were found on the left and right neck, the detection rate was 78%, 25 cases of vertigo were found on the neck and neck, The rate is 61%. TCD examination found bilateral bilateral vertebral artery blood flow asymmetry, bilateral vertebral artery diameter difference of 0.5 ~ 2.0mm in 30 cases, the detection rate was 73%. MRA showed that the diameter of bilateral vertebral artery was asymmetric, with a difference of 0.5-2.6 mm in 39 cases. The other two cases had bilateral vertebral artery stenosis with a detection rate of 95%. CONCLUSIONS: The tests of cervical rotation, kyphosis and head-to-head reversal confirm the occurrence of dizziness and vertigo in patients with vertebral artery stenosis. The diagnostic accuracy of TCD for diagnosis of vertebral artery stenosis is relatively high. MRA examines the vertebral artery Narrow the highest accuracy.