Seidel Günter, Cangür Hakan, Albers Thomas, Meyer-Wiethe Karsten
University Hospital Schleswig-Holstein, Campus Lübeck, Department of Neurology, Ratzeburger Allee 160, D-23538 Lübeck, Germany.
J Neuroimaging. 2005 Oct;15(4):326-30. doi: 10.1177/1051228405280174.
Previous studies indicate the potential of transcranial sonography (TCS) to detect cerebrovascular disease. The authors conducted this patient study to evaluate the diagnostic potential of gray-scale TCS in depicting hemorrhagic transformation (HT) in the early phase of middle cerebral artery infarction.
TCS was performed in 32 patients with acute ischemic stroke in the middle cerebral artery territory less than 12, 24 +/- 4, 72 +/- 6, and 120 +/- 12 hours after symptom onset (SONOS 5500, S4 probe, 16 cm investigation depth). Hemorrhagic transformation was identified as hyperechogenicity in the MCA territory, and the echogenicity of these areas was assessed. In addition, the dislocation of the third ventricle (midline shift, MLS) was assessed by TCS. Size and localization of infarction were determined by cranial computed tomography (CCT).
In 10 of 11 patients, TCS detected HT as confirmed by CCT. In 1 patient, TCS provided a false-positive result. In another patient, TCS was unable to detect the hemorrhage (sensitivity, 91%; specificity, 95%). The echointensity of HT increased over time. MLS measurement failed to predict fatal outcome in 1 patient.
TCS is a promising tool for depicting HT in patients with acute hemispheric stroke and might be suitable for monitoring purposes.
既往研究表明经颅超声检查（TCS）在检测脑血管疾病方面具有潜力。作者开展此项患者研究，以评估灰阶TCS在描绘大脑中动脉梗死早期出血性转化（HT）方面的诊断潜力。
对32例大脑中动脉区域急性缺血性卒中患者在症状发作后小于12小时、24±4小时、72±6小时和120±12小时进行TCS检查（SONOS 5500，S4探头，16 cm探测深度）。出血性转化被识别为大脑中动脉区域的高回声，对这些区域的回声进行评估。此外，通过TCS评估第三脑室的移位（中线移位，MLS）。梗死的大小和位置通过头颅计算机断层扫描（CCT）确定。
在11例患者中的10例中，TCS检测到的HT得到了CCT的证实。在1例患者中，TCS给出了假阳性结果。在另1例患者中，TCS未能检测到出血（敏感性为91%；特异性为95%）。HT的回声强度随时间增加。MLS测量未能预测1例患者的致命结局。
TCS是描绘急性半球性卒中患者HT的一种有前景的工具，可能适用于监测目的。
