Moritake K, Yonekawa Y, Nagasawa S, Kaneko T, Handa H
Department of Neurosurgery, Kyoto University Hospital, Japan.
No Shinkei Geka. 1987 Jul;15(7):709-15.
In 30 patients undergoing neurosurgical intervention, the authors evaluated the hemodynamics in the circle of Willis by transcranial Doppler sonography. By avoiding confusion with collateral effects, the transcranial Doppler sonography yielded direct and more significant information concerning the intracranial hemodynamics than extracranial Doppler sonography. Therefore, it made possible to detect intracranial occlusive lesions with less false findings. It gave us more accurate information on the effectiveness of reconstructive vascular surgery. In two of five consecutive patients with a proven aneurysmal subarachnoid hemorrhage, sound-spectrogram specific to stenosis was detected from the basal cerebral arteries which accompanied increase of the time-mean velocity of the upper spectrum and decrease of S/D ratio. Transcranial Doppler sonography was considered to contribute to the establishment of a protocol for early diagnosis and treatment of vasospasm. Transcranial Doppler sonography was also utilized as a useful tool for classification of arteriovenous malformation from the viewpoint of hemodynamics, namely high-flow or low-flow and with or without steal phenomenon. Transcranial Doppler sonography appears sufficiently promising to justify further development and utilization in cerebrovascular surgery.
在30例接受神经外科手术干预的患者中，作者通过经颅多普勒超声评估了 Willis 环的血流动力学。通过避免与侧支循环效应混淆，经颅多普勒超声比颅外多普勒超声能提供更直接、更重要的关于颅内血流动力学的信息。因此，它能够以更少的假阳性结果检测颅内闭塞性病变。它为我们提供了关于血管重建手术效果的更准确信息。在连续5例经证实为动脉瘤性蛛网膜下腔出血的患者中，有2例在基底脑动脉检测到了特定于狭窄的声谱图，同时上频谱的时间平均速度增加，S/D 比值降低。经颅多普勒超声被认为有助于制定血管痉挛的早期诊断和治疗方案。从血流动力学角度，即高流量或低流量以及有无盗血现象来看，经颅多普勒超声也被用作区分动静脉畸形的有用工具。经颅多普勒超声似乎具有足够的前景，值得在脑血管外科中进一步发展和应用。
