Tong Jing, Wang Shuo, Zhao Yuan-li, Zhao Ji-zong
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China.
Zhonghua Yi Xue Za Zhi. 2007 Apr 3;87(13):881-4.
To evaluate the reliability of intraoperative microvascular Doppler ultrasonography (MDU) in cerebral aneurysm surgery.
MDU was conducted among 46 patients with 51 cerebral aneurysms undergoing 47 operations to examine the blood flow velocity in the aneurysmal sac and in the adjacent vessels before and after aneurysm clipping.
MDU verified 6 cases of stenosis or occlusion of an adjacent vessel induced by clip positioning that had escaped detection by visual inspection (12.76%, 6/47). In addition, MDU demonstrated that one out of the 51 aneurysms failed to be occluded (1.96%). The incidence of stenosis, occlusion of adjacent vessel, and aneurysm failing to be occluded was closely correlated with the size of aneurysm, and such conditions were prone to occur in anterior communicating artery (ACoA) and internal carotid artery (ICA) aneurysms.
MDU should be used routinely in cerebral aneurysm surgery, especially in cases of giant aneurysms and aneurysms without obvious neck. In cases of ACoA and ICA aneurysms, MDU is more useful.
评估术中微血管多普勒超声（MDU）在脑动脉瘤手术中的可靠性。
对46例患有51个脑动脉瘤的患者进行了47次手术，术中应用MDU检测动脉瘤夹闭前后瘤腔内及相邻血管的血流速度。
MDU证实有6例因动脉瘤夹位置不当导致相邻血管狭窄或闭塞，肉眼检查未发现（12.76%，6/47）。此外，MDU显示51个动脉瘤中有1个未能闭塞（1.96%）。相邻血管狭窄、闭塞及动脉瘤未能闭塞的发生率与动脉瘤大小密切相关，且在前交通动脉（ACoA）和颈内动脉（ICA）动脉瘤中易发生。
MDU应常规应用于脑动脉瘤手术，尤其是巨大动脉瘤和无明显瘤颈的动脉瘤。对于ACoA和ICA动脉瘤，MDU更有用。
