Trauma Center, Armed Forces Capital Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.
Department of Neurosurgery, Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan, Gyeonggi-do, 15355, Republic of Korea.
Acta Neurochir (Wien). 2021 May;163(5):1503-1513. doi: 10.1007/s00701-020-04669-z. Epub 2021 Jan 6.
Color Doppler ultrasonography (CDUS) is used to evaluate the surgical success and postoperative hemodynamic changes of patients who receive superficial temporal to middle cerebral artery (STA-MCA) bypass surgery. Previous studies enrolled small populations, and difficulties interpreting the results have limited their use in clinical settings.
We attempted to determine the feasibility of using CDUS to evaluate STA hemodynamics and identify the most reliable parameter as a new clinical implication for determining bypass patency.
Twenty-six patients who underwent STA-MCA bypass surgery were prospectively enrolled. Four times CDUS and two times digital subtraction angiography (DSA) were performed. The CDUS parameters were compensated using the ratio of the operated to the non-operated sides (R1) and compared before and after surgery (R2). The CDUS parameters are then compared with the patency on DSA by statistical analyses.
Increased CDUS parameters of the mean flow rate (MFR) and cross-sectional diameter (CSD) showed significant correlations with good patency on DSA. The R2 at 1 month was identified as the most reliable parameter for predicting the patency in both MFR and CSD. Their cutoff values were 1.475 and 1.15, respectively.
CDUS can be utilized for predicting the patency after STA-MCA bypass surgery; if the postoperative (compensated and compared) CDUS parameters increased by more than 47.5% in the MFR or 15% in the CSD, the patency of the anastomosis on DSA would be good.
彩色多谱勒超声（CDUS）用于评估接受颞浅动脉-大脑中动脉（STA-MCA）搭桥手术患者的手术成功率和术后血流动力学变化。先前的研究纳入的患者数量较少，并且结果解释困难限制了它们在临床环境中的应用。
我们试图确定使用 CDUS 评估 STA 血流动力学的可行性，并确定最可靠的参数作为确定旁路通畅性的新临床意义。
前瞻性纳入 26 例行 STA-MCA 搭桥手术的患者。进行了 4 次 CDUS 和 2 次数字减影血管造影（DSA）。使用患侧与健侧的比值（R1）对 CDUS 参数进行校正，并在手术前后进行比较（R2）。然后通过统计学分析将 CDUS 参数与 DSA 的通畅性进行比较。
平均血流速度（MFR）和横截面积（CSD）的 CDUS 参数增加与 DSA 上良好的通畅性呈显著相关。术后 1 个月的 R2 被确定为预测 MFR 和 CSD 通畅性的最可靠参数。其截断值分别为 1.475 和 1.15。
CDUS 可用于预测 STA-MCA 搭桥手术后的通畅性；如果术后（校正并比较）MFR 的 CDUS 参数增加超过 47.5%或 CSD 的增加超过 15%，DSA 上吻合口的通畅性将良好。
