Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
World Neurosurg. 2011 Feb;75(2):258-63. doi: 10.1016/j.wneu.2010.09.008.
To observe the hemodynamic changes of the superficial temporal artery (STA) by color Doppler and the correlation between the results of angiography and the hemodynamic changes of the STA after superficial temporal artery-middle cerebral artery (STA-MCA) bypass surgery for moyamoya disease.
This study included 26 cases of moyamoya disease; standard STA-MCA bypass surgery were performed in all patients. GE-LOGIQ9 color ultrasound with 7L transducer was used to monitor STA hemodynamic changes, including peak systolic velocity (PSV), end-diastolic velocity (EDV), mean flow velocity (Vm), pulse index (PI), and resistance index (RI), preoperatively and 1 week and 3 months after surgery in 10 cases. In 22 cases, color Doppler of STA and digital subtraction angiography of the external carotid artery (ECA), internal carotid artery (ICA), common carotid artery (CCA), and vertebral artery (VA) were performed preoperatively and 1 week after surgery. Based on the patency of STA-MCA on angiography, the patients were divided into two groups: 11 patients were in the patent group, and 11 patients were in the nonpatent group. Statistical significance was evaluated using analysis of variance of random block design and paired samples t test. SPSS software version 11.5 was used.
In the 10 cases, there was no significant difference among the three imaging series in PSV. Compared with the preoperative values, the values of EDV and Vm 1 week and 3 months after surgery were significantly higher (P < 0.05). The difference was not significant, however, between 1 week and 3 months after surgery. The PI and RI at 1 week and 3 months after surgery were significantly lower than the preoperative values (P < 0.05); there was no significant difference between 1 week and 3 months after surgery. Among the 22 cases, the values of PSV, EDV, and Vm increased significantly (P < 0.05) and the values of PI and RI decreased significantly(P < 0.01) after surgery in the patent group. In the nonpatent group, the values of PSV and PI decreased significantly after surgery (P < 0.05). EDV, Vm, and RI had no significant changes after surgery.
Higher blood flow can develop in anastomosed STA after STA-MCA bypass surgery. The hemodynamic changes of STA after surgery mainly occurred at an early period after operation with little change at 3-month follow-up examination. The increase of blood flow in STA may be due to the low resistance of the intracranial vascular bed. Postoperative Doppler examination of the STA may predict angiographic results of the anastomosis in the early postoperative period. Continuous observation is necessary to identify an accurate correlation between quantitative alteration of the Doppler parameters and angiographic results.
观察彩色多谱勒（CDFI）检测颞浅动脉（STA）血流动力学变化，并探讨其与颅内外动脉搭桥术（STA-MCA）后吻合血管通畅情况的相关性。
采用 7L 探头的 GE-LOGIQ9 彩色超声仪，对 26 例烟雾病患者行 STA-MCA 搭桥术，分别于术前及术后 1 周、3 个月检测 STA 收缩期峰值血流速度（PSV）、舒张末期血流速度（EDV）、平均血流速度（Vm）、搏动指数（PI）及阻力指数（RI）的变化。22 例患者术前及术后 1 周行 STA 及颅外段颈内动脉（ICA）、颈外动脉（ECA）、颈总动脉（CCA）、椎动脉（VA）的 CDFI 及数字减影血管造影（DSA）检查。根据术后 STA-MCA 吻合口的通畅情况，将患者分为通畅组 11 例，未通畅组 11 例。采用随机区组方差分析和配对 t 检验进行统计学分析，应用 SPSS11.5 统计软件。
10 例患者术后各时间段 PSV 比较，差异均无统计学意义（F=0.532，P=0.596）。EDV、Vm 于术后 1 周及 3 个月时均较术前明显增高（P<0.05），但术后 1 周与 3 个月时比较，差异无统计学意义（P=0.542）。PI、RI 于术后 1 周及 3 个月时均较术前明显降低（P<0.05），术后 1 周与 3 个月时比较，差异亦无统计学意义（P=0.557）。22 例患者中，通畅组术后 PSV、EDV、Vm 均较术前明显增高（P<0.05），PI、RI 则较术前明显降低（P<0.01）；未通畅组中，PSV、PI 于术后均较术前明显降低（P<0.05），而 EDV、Vm、RI 于术后与术前比较，差异均无统计学意义（P>0.05）。
STA-MCA 搭桥术后吻合 STA 血流速度增快，术后早期 STA 血流动力学改变明显，3 个月时复查变化不明显。STA 血流速度的增快可能与颅内血管床低阻力有关。术后 STA 多普勒检测可预测早期吻合口的通畅情况，需要进一步连续观察以明确多普勒参数定量改变与血管造影结果的相关性。
