Wan Yuxiao, Teng Xiufei, Li Shiyi, Yang Yanchao
Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, China.
Front Aging Neurosci. 2022 Nov 8;14:1035086. doi: 10.3389/fnagi.2022.1035086. eCollection 2022.
Transcranial Doppler (TCD) is a rapid and non-invasive diagnostic technique that can provide real-time measurements of the relative changes in cerebral blood velocity (CBV). Therefore, TCD is a useful tool in the diagnosis and treatment of clinical cerebrovascular diseases (CVDs). In this review, the basic principles of TCD and its application in CVD were outlined. Specifically, TCD could be applied to evaluate occlusive CVD, assess collateral circulation in patients with ischemic stroke, and monitor cerebral vascular occlusion before and after thrombolysis as well as cerebral vasospasm (VSP) and microembolization signals after aneurysmal subarachnoid hemorrhage (SAH). Moreover, TCD could predict short-term stroke and transient cerebral ischemia in patients with anterior circulation occlusion treated with endovascular therapy and in patients with anterior circulation vascular occlusion. Additionally, TCD not only could monitor blood velocity signals during carotid endarterectomy (CEA) or carotid artery stenting (CAS) but also allowed earlier intervention through early recognition of sickle cell disease (SCD). Presently, TCD is a useful prognostic tool to guide the treatment of CVD. On the one hand, TCD is more commonly applied in clinical research, and on the other hand, TCD has an increasing role in the management of patients. Collectively, we review the principles and clinical application of TCD and propose some new research applications for TCD.
经颅多普勒(TCD)是一种快速且无创的诊断技术,能够实时测量脑血流速度(CBV)的相对变化。因此,TCD是临床脑血管疾病(CVD)诊断和治疗中的一种有用工具。在本综述中,概述了TCD的基本原理及其在CVD中的应用。具体而言,TCD可用于评估闭塞性CVD、评估缺血性卒中患者的侧支循环、监测溶栓前后的脑血管闭塞以及动脉瘤性蛛网膜下腔出血(SAH)后的脑血管痉挛(VSP)和微栓塞信号。此外,TCD可以预测接受血管内治疗的前循环闭塞患者和前循环血管闭塞患者的短期卒中及短暂性脑缺血。另外,TCD不仅可以在颈动脉内膜切除术(CEA)或颈动脉支架置入术(CAS)期间监测血流速度信号,还能通过早期识别镰状细胞病(SCD)实现更早的干预。目前,TCD是指导CVD治疗的一种有用的预后工具。一方面,TCD在临床研究中应用更为普遍,另一方面,TCD在患者管理中发挥着越来越重要的作用。总体而言,我们综述了TCD的原理和临床应用,并提出了一些TCD的新研究应用。