VA-ECMO 急性相神经影像学的挑战、误区及替代影像学选择。
Challenges of acute phase neuroimaging in VA-ECMO, pitfalls and alternative imaging options.
机构信息
Department of Neurology, Henry Ford Hospital, Detroit, MI, USA.
Department of Radiology, Henry Ford Hospital, Detroit, MI, USA.
出版信息
Interv Neuroradiol. 2021 Jun;27(3):434-439. doi: 10.1177/1591019920962881. Epub 2020 Sep 29.
Abstract
Large vessel occlusion in patients on ECMO is challenging to appreciate clinically secondary to sedation or induced paralysis, thus placing more emphasis on neurovascular imaging. However, emergent CTA and CTP are both inaccurate and unreliable in ECMO patients due to altered circuitry and interference with normal physiologic hemodynamics. In this review, the utility of DSA is discussed in evaluating the altered hemodynamics of VA-ECMO circuits and patency of major vasculature. In addition, the potential use of TCD in ECMO patients is discussed.
摘要
体外膜肺氧合（ECMO）患者的大血管闭塞在临床上难以识别，这可能是由于镇静或诱导麻痹，因此更强调神经血管成像。然而，由于电路改变和对正常生理血流动力学的干扰，紧急 CTA 和 CTP 在 ECMO 患者中均不准确且不可靠。在这篇综述中，讨论了 DSA 在评估 VA-ECMO 回路改变的血流动力学和主要血管通畅性中的应用。此外，还讨论了 TCD 在 ECMO 患者中的潜在应用。
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