Iglseder B, Huemer M, Staffen W, Ladurner G
Department of Neurology, Christian-Doppler-Klinik, Salzburg, Austria.
J Neuroimaging. 2000 Oct;10(4):195-9. doi: 10.1111/jon2000104195.
Conventional transcranial color-coded real-time sonography of the vertebrobasilar system is limited by imaging problems of the distal segment of the basilar artery. Lung-stable contrast-enhancing agents may overcome this problem by enhancing the quality of Doppler signals by as much as 20%. Fourty-two patients underwent sonographic evaluation of the vertebrobasilar system before and after receiving intravenously administered galactose-based contrast-enhancing agent Levovist by transforaminal and transtemporal routes. Imaging quality was classified into five categories depending on the length of visible color-flow by transforaminal approach: 1--no signal, 2--1-9.9 mm, 3--10-19.9 mm, 4--20-29.9 mm, 5--> or = 30 mm. For transtemporal insonation, imaging quality was classified either as no color flow or sufficient color flow of the basilar tip. By unenhanced investigation, average signal length of color flow was 16 +/- 8 mm for transforaminal investigation; application of Levovist improved this value to 26.6 +/- 6 mm. For unenhanced transforminal approach, 4.8% were assigned to category 1, 11.9% to category 2, 54.8% to category 3, 23.8% to category 4 and 4.8% to category 5. After signal enhancement with Levovist, category 1 covered 0%, category 2 2.4%, category 3 7.14%, category 4 59.5% and category 5 30.9% (p < 0.001). Unenhanced transtemporal approach allowed identification of the basilar tip in 78.6% with an average length of 6.3 +/- 2 mm; contrast enhancement improved this values to 92.9% and 8.3 +/- 3.3 mm respectively (p < 0.05). The application of transpulmonary contrast-enhancing agents improves the reliability of transcranial color-coded duplex sonography of the basilar artery.
传统的经颅彩色编码实时超声对椎基底动脉系统的检查受限于基底动脉远段的成像问题。肺稳定型对比增强剂可通过将多普勒信号质量提高多达20%来克服这一问题。42例患者在经椎间孔和经颞途径静脉注射基于半乳糖的对比增强剂Levovist前后接受了椎基底动脉系统的超声评估。根据经椎间孔途径可见彩色血流的长度，将成像质量分为五类：1类——无信号，2类——1 - 9.9毫米，3类——10 - 19.9毫米，4类——20 - 29.9毫米，5类——≥30毫米。对于经颞部探测，成像质量分为基底动脉尖无彩色血流或有足够彩色血流。在未增强检查时，经椎间孔检查的彩色血流平均信号长度为16±8毫米；应用Levovist后该值提高到26.6±6毫米。对于未增强的经椎间孔途径，4.8%属于1类，11.9%属于2类，54.8%属于3类，23.8%属于4类，4.8%属于5类。在用Levovist增强信号后，1类占0%，2类占2.4%，3类占7.14%，4类占59.5%，5类占30.9%（p<0.001）。未增强的经颞部途径在78.6%的病例中可识别基底动脉尖，平均长度为6.3±2毫米；对比增强后该值分别提高到92.9%和8.3±3.3毫米（p<0.05）。经肺对比增强剂的应用提高了基底动脉经颅彩色编码双功超声检查的可靠性。
