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摘要： 目的 探索分层递进式教学模式在血管超声专业对进修医师的培训效果。 方法 纳入2021年1月—2023年3月于首都医科大学宣武医院血管超声科进修的医师124人，根据入科时医师对血管超声和TCD技术的掌握水平进行分层，分为单技术组和颈-脑一体化技术组，采用分层递进式教学模式培训满6个月后，进行理论及实践考核。 结果 单技术组及颈-脑一体化技术组在入科时理论考核成绩和上机操作考核成绩差异无统计学意义。通过分层递进式教学培训后，单技术组的理论考核成绩[（83.8±6.9）分 vs.（65.2±9.6）分，P＜0.001]和上机操作考核成绩[（93.2±4.5）分 vs.（91.4±4.3）分，P＜0.001]均有提高。颈-脑一体化技术组理论考核成绩提高[（86.9±7.7）分 vs.（67.7±6.4）分，P＜0.001]。 结论 分层递进式教学模式在血管超声专业对进修医师具有较好的教学效果和较高的教学满意度。 Abstract: Objective To explore the training effect of hierarchical and progressive teaching mode on continuing educational physicians in the field of vascular ultrasound. Methods A total of 124 physicians studying in Vascular Ultrasound Department of Xuanwu Hospital, Capital Medical University from January 2021 to March 2023 were included. They were divided into the single technique group and the integrated technique group based on their mastery of vascular ultrasound and TCD technology at the beginning. After 6 months of training with hierarchical and progressive teaching mode, the theoretical and operational assessments were examed. Results There was no significant difference in theoretical assessment scores and operational assessment scores between the single technique group and the integrated technique group when enrolled. After the training with hierarchical and progressive teaching, the theoretical assessment scores [(83.8±6.9) points vs. (65.2±9.6) points, P

超声由于其独特的优势已逐渐应用于脑小血管病领域。本文汇总了超声在脑小血管病中应用的相关研究，概述了脑小血管病与血管超声各类评估指标之间的关系，并描述了超声在与脑小血管病并存的心、脑、肾等多系统疾病中的评估、诊断作用，为应用超声对脑小血管病进行全面有效评估提供了理论依据。 Abstract: Ultrasound has been gradually applied to the field of cerebral small vessel disease (CSVD) due to its unique advantages. This paper summarized the studies related to ultrasound in CSVD, and summarized the relationship between CSVD and various evaluation indicators of vascular ultrasound. What’s more, this paper described the role of ultrasound in the evaluation and diagnosis of multi-system diseases such as heart, brain, and kidney coexisting with CSVD, and provided a theoretical basis for comprehensive and effective evaluation of CSVD by ultrasound.

永存动脉是永久性颈内动脉和椎基底动脉之间的异常吻合，是一种较罕见的脑血管变异。通常，永存动脉具有供血功能，不引起任何特殊临床症状，但若伴发动脉粥样硬化性病变和其他血管变异，会导致临床表现复杂化。目前，超声是临床评估头颈血管病变的首选检查方法，正确诊断永存动脉，可以更准确地解释与其相关的临床表现，在进行相应手术或介入操作时，可避免不当操作的风险。永存动脉多为影像学检查偶然发现，其影像学表现具有特征性。目前，国内外不乏对永存动脉的影像学诊断报道，但缺乏超声对永存动脉分型及其血流动力学的评估报道。本文结合文献，创新性地提出永存动脉的超声诊断思路和分型，旨在提高对永存动脉的早期准确诊断率。 Abstract: Persistent artery is an abnormal anastomotic branch between the permanent internal carotid artery and the vertebrobasilar artery, which is a rare cerebrovascular variation. Typically, persistent arteries have a blood supply function and do not cause specific clinical symptoms; however, when accompanied by atherosclerotic lesions of the arteries and other vascular variants, they result in a complex clinical presentation. At present, ultrasonography is the first choice for clinical evaluation of cerebral and cervical vascular abnormalities. Correct diagnosis of persistent arteries improves clinical interpretation and reduces the risk of improper operation during related surgical or interventional procedures. Most persistent arteries are discovered incidentally through imaging, and their imaging manifestations are characteristic. There are many reports on the imaging diagnosis of persistent arteries at home and abroad, but few on ultrasonography staging and hemodynamics. Based on the literature, this paper innovatively proposed an ultrasound diagnostic concept and staging of the persistent artery in an effort to improve the early and accurate diagnosis of the persistent artery.

Copyright of Chinese Journal of Stroke is the property of Chinese Journal of Stroke Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Stroke is the property of Chinese Journal of Stroke Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Stroke is the property of Chinese Journal of Stroke Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

背景 偏头痛与右向左分流（right-to-left shunt，RLS）的关系尚有争议。本研究旨在明确中国偏头痛 患者右向左分流的阳性率、分流类型以及分流量大小，分析偏头痛与右向左分流的关系。 方法 该研究为多中心-病例对照研究（北美临床研究注册号NCT0242569)。由中国9家分中心共同完 成，连续纳入2015年6月-2016年8月就诊于分中心且符合据第三版国际头痛疾病分类-β测试版（The International Classification of Headache Disorders 3rd Edition Beta Version，ICHD-3β）诊断偏头痛的患 者（18～65周岁），为偏头痛组。偏头痛组共纳入931例（女性695例），其中先兆偏头痛240例（女性174 例），无先兆偏头痛691例（女性521例）。健康对照组共282例。 结果 先兆偏头痛组RLS阳性率和大量分流比例高于无先兆偏头痛组（63.7% vs 39.9%，P＜0.001； 32.1% vs 16.5%，P＜0.001），两组中量和小量分流比例无差异（P =0.141；P =0.061）。无先兆偏头痛 组RLS阳性率和大量分流比例高于对照组（39.9% vs 29.4%，P＜0.001；16.5% vs 6.4%，P＜0.001）， 两组间中量和小量分流的比例无差异。 结论 偏头痛患者（包括有先兆和无先兆偏头痛患者），右向左分流阳性率高于正常对照组，且以大 量右向左分流为主，中至小量右向左分流及分流的类型与对照组相比无差异。右向左分流，特别是大 量的右向左分流，可能与偏头痛有关。 Abstract: Background The association between Right-to-left shunt (RLS) and migraine was still controversial. The aim of this study was to investigate the prevalence, grade and volume of RLS in Chinese patients with migraine and to evaluate the relationship between RLS and migraine. Methods It was a multi-center case-control study with North America Clinical Study Registration No. NCT02425696, and underwent jointly by 9 sunb-centers in China. The patients, aged between 18 years old to 65 years old, who received consultation services in sub-centers and were diagnosed as migraine according to The International Classification of Headache Disorders 3rd Edition Beta Version (ICHD-3 β) during June 2015 to August 2016, were consecutively enrolled into migraine group. There were 931 patients in migraine group, among which, there were 695 cases of female. There were 240 cases of migraine with aura and 691 cases of migraine without aura. There were 282 healthy adults in control group. Results The prevalence of RLS were 63.7% and 39.9% in the migraine with aura group (MA+) and migraine without aura group (MA-), respectively, which were significantly higher than that of healthy group (29.4%, P