Sekhar L N, Wasserman J F
J Neurosurg. 1984 Mar;60(3):553-9. doi: 10.3171/jns.1984.60.3.0553.
Using an electronic stethoscope, the authors have attempted noninvasive detection of intracranial aneurysms, arteriovenous malformations (AVM's), and carotid cavernous fistulas in 45 patients. A microphone of older design and a newly designed horn-coupled probe microphone were used to record the sound signals emanating from the cranium. A trigger pulse recorded by another microphone placed over the carotid area or the precordium was used to time the intracranial signals. The sound signals were converted to electrical signals, amplified, filtered, and analyzed using fast Fourier transformation to give plots of amplitude versus frequency of the signals. A spike at a certain frequency or a bruit over a band of frequencies was considered a positive finding. The records of 18 of the patients were not satisfactory for analysis, mainly due to external noise interference. Eight of 11 aneurysm patients with satisfactory recordings emitted resonant spikes, turbulent bruits, or combinations of the two. The other three records were negative. Four patients with AVM's and two with carotid cavernous fistulas exhibited broad-band bruits representing turbulent flow. Neither spikes nor bruits were demonstrable in three patients with brain tumors or in seven patients without intracranial vascular lesions. Experimental vein pouch aneurysms were also induced in two dogs. Recordings from these animals revealed resonant spikes. The limitations and scope of electronic stethoscope audiometry are discussed.
作者使用电子听诊器对45例患者进行了颅内动脉瘤、动静脉畸形（AVM）和颈动脉海绵窦瘘的无创检测。采用老式设计的麦克风和新设计的喇叭耦合探头麦克风记录来自颅骨的声音信号。置于颈动脉区或心前区的另一个麦克风记录的触发脉冲用于对颅内信号进行计时。声音信号被转换为电信号，经过放大、滤波，并使用快速傅里叶变换进行分析，以给出信号幅度与频率的曲线图。特定频率处的尖峰或一段频率范围内的杂音被视为阳性发现。18例患者的记录因外部噪声干扰而无法进行分析。11例动脉瘤患者中，有8例记录良好，出现了共振尖峰、湍流杂音或两者兼有。另外3例记录为阴性。4例AVM患者和2例颈动脉海绵窦瘘患者表现出代表湍流的宽带杂音。3例脑肿瘤患者和7例无颅内血管病变的患者均未检测到尖峰或杂音。还在两只狗身上诱发了实验性静脉瘤样动脉瘤。这些动物的记录显示出共振尖峰。本文讨论了电子听诊器测听法的局限性和适用范围。
