Hacettepe University Hospitals, Department of Neurology, Neurosonology Laboratory, Neurological Intensive Care Unit, Ankara, Turkey.
J Neurochem. 2012 Nov;123 Suppl 2:39-51. doi: 10.1111/j.1471-4159.2012.07942.x.
Albeit no direct anatomical information can be obtained, neurosonological methods provide real-time determination of velocity, and spectral waveform of blood flow in basal intracranial arteries adds significant benefit to the care of the patients with neurovascular diseases. Several features, such as relative simplicity in terms of interpretation and performance, significantly low cost, totally non-invasiveness, portability, and excellent temporal resolution, make neurosonology increasingly popular tool for evaluation, planning, and monitoring of treatment, and for determining prognosis in various neurovascular diseases. Usefulness of transcranial Doppler in diagnosing/monitoring subarachnoid hemorrhage related vasospasm and sickle cell vasculopathy is already well known. Utility in diagnosis of intracranial arterial stenosis, acute occlusion and recanalization, intracranial hemodynamic effect of the cervical arterial pathologies, intracranial pressure increase, and cerebral circulatory arrest are also well established. Neurosonological determination of vasomotor reactivity, cerebral autoregulation, neurovascular coupling, and micro-embolic signals detection are useful in the assessment of stroke risk, diagnosis of right-to-left shunting, and monitoring during surgery and interventional procedures. Transcranial Doppler is also an evolving ultrasound method with a therapeutic potential such as augmentation of clot lysis and cerebral delivery of thrombolytic or neuroprotective agent loaded nanobubbles in neurovascular diseases. The aim of this study is to give an overview of current usage of the different ultrasound modalities in different neurovascular diseases.
尽管不能直接获得解剖学信息，但神经超声方法可以实时确定基底颅内动脉的血流速度和频谱波形，这为神经血管疾病患者的治疗提供了重要的帮助。神经超声具有解释和操作相对简单、成本低、完全无创、便携、时间分辨率高等特点，因此越来越成为评估、规划和监测治疗以及确定各种神经血管疾病预后的重要工具。经颅多普勒在诊断/监测蛛网膜下腔出血相关血管痉挛和镰状细胞血管病变中的作用已得到广泛认可。其在诊断颅内动脉狭窄、急性闭塞和再通、颈动脉硬化病变对颅内血流动力学的影响、颅内压升高和脑循环停止方面的作用也已得到充分证实。神经超声对血管舒缩反应性、脑自动调节、神经血管耦合和微栓子信号检测的测定有助于评估中风风险、诊断右向左分流以及监测手术和介入过程。经颅多普勒也是一种具有治疗潜力的超声方法，例如在神经血管疾病中增强血栓溶解以及将载有溶栓或神经保护剂的纳米气泡输送到大脑。本研究旨在概述不同神经血管疾病中不同超声模式的当前应用。
