Park Jiyong, Hwang Sung-Kyun
Department of Neurosurgery, College of Medicine, Ewha Womans University, Mokdong Hospital, Seoul, Korea.
J Cerebrovasc Endovasc Neurosurg. 2021 Dec;23(4):334-342. doi: 10.7461/jcen.2021.E2021.05.001. Epub 2021 Sep 28.
Pulsatility index (PI) is a parameter calculated by transcranial Doppler sonography (TCD), which is commonly used for patients with subarachnoid hemorrhage or ischemic stroke. However, we performed a retrospective analysis of patients with acute spontaneous intracerebral hemorrhage (ICH) to assess the function of TCD, particularly the PI.
This study involved a total of 46 patients with acute ICH who received treatment at a single center between May 2013 and December 2014. Medical records of baseline characteristics, except for the modified Rankin scale, were obtained at initial evaluation in the emergency room, and TCD was used to calculate middle cerebral artery flow velocity (MFV) and PI at admission (baseline), 24 h, and 7 days. The PI and MFV values on the affected middle cerebral artery were compared with those on the contralateral side. Linear regression analysis was used for statistical analyses (SPSS 21.0, IBM Corp., Armonk, NY, USA).
Statistical analysis indicated that sex, age, Glasgow coma scale, intraventricular hemorrhage, and hematoma size were not correlated with PI (p>0.05); however, only PI was positively correlated with functional outcome at 6 months after treatment (R=0.846, p=0.002).
These results provide evidence that the parameter of PI is an independent determinant prognostic factor in acute spontaneous ICH. Further research is needed to investigate the influence of cerebral blood flow dynamics on a larger, more controlled, and more randomized basis.
搏动指数(PI)是经颅多普勒超声(TCD)计算得出的一个参数,常用于蛛网膜下腔出血或缺血性卒中患者。然而,我们对急性自发性脑出血(ICH)患者进行了一项回顾性分析,以评估TCD的功能,尤其是PI。
本研究共纳入了2013年5月至2014年12月在单一中心接受治疗的46例急性ICH患者。在急诊室初始评估时获取除改良Rankin量表外的基线特征医疗记录,并在入院时(基线)、24小时和7天时使用TCD计算大脑中动脉血流速度(MFV)和PI。将患侧大脑中动脉的PI和MFV值与对侧进行比较。采用线性回归分析进行统计分析(SPSS 21.0,IBM公司,美国纽约州阿蒙克)。
统计分析表明,性别、年龄、格拉斯哥昏迷量表、脑室内出血和血肿大小与PI均无相关性(p>0.05);然而,仅PI与治疗后6个月的功能结局呈正相关(R=0.846,p=0.002)。
这些结果证明PI参数是急性自发性ICH的一个独立预后决定因素。需要进一步开展研究,在更大规模、更具对照性和随机性的基础上探究脑血流动力学的影响。