Department of Medicine Ultrasonics, People's Hospital of Dezhou, Dezhou, Shangdong, China.
Eur Rev Med Pharmacol Sci. 2017 Jun;21(11):2757-2763.
To evaluate the changes in cerebral hemodynamics of patients with different degrees of cerebral vasospasm before and after the nimodipine treatment using transcranial two-dimensional and color Doppler ultrasonography (TCCS).
A total of 77 patients with subarachnoid hemorrhage was collected; and the maximum peak systolic velocity (Vs), end diastolic velocity (Vd), time averaged maximum velocity (Vm), pulsatility index (PI) and resistance index (RI) of middle cerebral artery (MCA) were measured by spectral Doppler technique. The standard-dose nimodipine was given for clinical treatment, and changes in blood flow velocity of MCA were monitored by TCCS, and the therapeutic effect was observed.
68 out of 77 patients (88.3%) with subarachnoid hemorrhage were diagnosed as cerebral vasospasm (CVS), including 53 cases (77.9%) of mild spasm, 11 cases (16.2%) of moderate spasm and 4 cases (5.9%) of severe spasm. The sensibility of CVS detected by TCCS after operation was 88.3%. Color Doppler flow imaging (CDFI) showed that the blood flow was multicolored. After the nimodipine treatment, the measured values of MCA-Vs and RI were decreased in different degrees compared with those before treatment.
Nimodipine has improving effects on CVS in different degrees, and TCCS can be used to evaluate the therapeutic effects on CVS.
应用经颅二维彩色多谱勒超声(TCCS)评价不同程度脑血管痉挛患者尼莫地平治疗前后脑血流动力学的变化。
收集 77 例蛛网膜下腔出血患者,应用频谱多普勒技术检测大脑中动脉(MCA)的最大收缩期峰值流速(Vs)、舒张末期流速(Vd)、平均流速(Vm)、搏动指数(PI)及阻力指数(RI)。给予标准剂量尼莫地平进行临床治疗,通过 TCCS 监测 MCA 血流速度的变化,并观察治疗效果。
77 例蛛网膜下腔出血患者中,68 例(88.3%)诊断为脑血管痉挛(CVS),其中轻度痉挛 53 例(77.9%),中度痉挛 11 例(16.2%),重度痉挛 4 例(5.9%)。TCCS 术后对 CVS 的检出率为 88.3%。彩色多谱勒血流成像(CDFI)显示血流呈五彩镶嵌样。尼莫地平治疗后,MCA-Vs 及 RI 较治疗前均有不同程度的降低。
尼莫地平对不同程度的 CVS 均有改善作用,TCCS 可用于评价 CVS 的治疗效果。