Tsai Li-Kai, Liu Hon-Man, Lu Chien-Jung, Jeng Jiann-Shing, Yip Ping-Keung
Department of Neurology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei.
AJNR Am J Neuroradiol. 2005 Mar;26(3):625-9.
Studies to determine the value of noninvasive neurovascular studies for the effectiveness of treatment and long-term follow-up of dural arteriovenous fistulas (AVFs) are of clinical importance. We determined whether the serial changes of carotid duplex sonography (CDS) were correlated with the evolution of dural AVF status after treatment or follow-up.
Four parameters of CDS were studied in two groups of patients with dural AVF: resistance index, end diastolic velocity, peak systolic velocity, and flow volume of the external carotid artery (ECA). The first group included 13 patients who received endovascular therapy, the efficacy of which was determined by the results of postembolization angiography. In the second group, 16 patients received only clinical and CDS follow-up. Evolution of clinical symptoms was recorded and classified as deteriorating, stationary, or improving. Patients underwent CDS before and after treatment (group 1) or at long-term follow-up (group 2).
In the first group, the resistance index of the ECA increased in patients with occluded or nearly occluded dural AVF after embolization (n = 7, P = .01), but it did not change significantly in patients with partial treatment (n = 6, P = .11). Of patients with occluded or nearly occluded dural AVF after embolization, the ECA resistance index increased in patients with noncavernous sinus dural AVF (n = 5, P = .003) but not in patients with cavernous sinus dural AVF (n = 2, P = .48). In the second group, CDS parameters-particularly the resistance index-were well correlated with clinical status during follow-up.
The resistance index of the ECA is correlated with the effectiveness of treatment and clinical evolution of dural AVF.
确定无创性神经血管检查对于硬脑膜动静脉瘘（dural arteriovenous fistulas，DAVF）治疗效果及长期随访价值的研究具有临床重要性。我们判定颈动脉双功超声（carotid duplex sonography，CDS）的系列变化是否与治疗或随访后硬脑膜AVF状态的演变相关。
在两组硬脑膜AVF患者中研究CDS的四个参数：阻力指数、舒张末期速度、收缩期峰值速度以及颈外动脉（external carotid artery，ECA）的血流量。第一组包括13例接受血管内治疗的患者，其治疗效果由栓塞后血管造影结果判定。第二组16例患者仅接受临床及CDS随访。记录临床症状的演变并分类为恶化、稳定或改善。患者在治疗前和治疗后（第一组）或长期随访时（第二组）接受CDS检查。
在第一组中，栓塞后硬脑膜AVF闭塞或接近闭塞的患者（n = 7，P = .01）ECA阻力指数升高，但部分治疗的患者（n = 6，P = .11）无显著变化。栓塞后硬脑膜AVF闭塞或接近闭塞的患者中，非海绵窦硬脑膜AVF患者（n = 5，P = .003）的ECA阻力指数升高，而海绵窦硬脑膜AVF患者（n = 2，P = .48）则未升高。在第二组中，CDS参数——尤其是阻力指数——与随访期间的临床状态密切相关。
ECA阻力指数与硬脑膜AVF的治疗效果及临床演变相关。
