Soehle M, Heimann A, Kempski O
Institute for Neurosurgical Pathophysiology, Johannes Gutenberg-University, Mainz, Germany.
Acta Neurochir Suppl. 2000;76:181-4. doi: 10.1007/978-3-7091-6346-7_36.
This study was initiated to determine the optimal number of measuring sites necessary to estimate regional cerebral blood flow (CBF) under pathophysiological conditions. 25 rats were exposed to 15 minutes of global cerebral ischemia. Local CBF was sequentially measured by laser Doppler (LD) at 32 locations during baseline conditions, ischemia and reperfusion using a computer-controlled scanning technique. A simulation study was performed based on 800 local measurements at each time point: random samples (size 1-100) were repeatedly drawn to estimate the variability of median flow. Accuracy was defined as probability that the simulated median differed less than +/- 5 LD-units from the true median of the 800 data. Above a single location, CBF was measured with an accuracy of 21.6 +/- 0.4% (baseline conditions, n = 100 simulations, mean +/- SEM), 85.8 +/- 0.4% (ischemia) and 11.1 +/- 0.3% (30th min. reperfusion). Accuracy increases to 75.2 +/- 0.5% (baseline conditions), 100 +/- 0% (ischemia) and 41.8 +/- 0.6% (30th min. reperfusion) if 24 locations are scanned. Scanning, therefore, improves accuracy and reduces variability of CBF measurements. With enough local CBF measurements laser Doppler assessment of regional CBF is possible. Single location CBF assessment is sufficiently accurate only during ischemia. During reperfusion, when accuracy is half reduced compared to baseline conditions, larger sample sizes are required.
本研究旨在确定在病理生理条件下估计局部脑血流量(CBF)所需的最佳测量部位数量。25只大鼠经历了15分钟的全脑缺血。在基线条件、缺血和再灌注期间,使用计算机控制的扫描技术通过激光多普勒(LD)在32个位置依次测量局部脑血流量。基于每个时间点的800次局部测量进行了模拟研究:反复抽取随机样本(大小为1 - 100)以估计中位血流量的变异性。准确性定义为模拟中位值与800个数据的真实中位值相差小于±5 LD单位的概率。在单个测量部位以上,测量CBF的准确性在基线条件下为21.6 ± 0.4%(n = 100次模拟,均值±标准误),缺血时为85.8 ± 0.4%,再灌注第30分钟时为11.1 ± 0.3%。如果扫描24个部位,准确性在基线条件下提高到75.2 ± 0.5%,缺血时为100 ± 0%,再灌注第30分钟时为41.8 ± 0.6%。因此,扫描可提高准确性并降低CBF测量的变异性。通过足够的局部CBF测量,激光多普勒评估局部CBF是可行的。单个部位的CBF评估仅在缺血期间足够准确。在再灌注期间,与基线条件相比准确性降低一半,需要更大的样本量。