Duong H, Tampieri D, TerBrugge K G, Leblanc R, Melançon D, Olivier A, Alwatban J
Montreal Neurological Institute, Que.
Can Assoc Radiol J. 1994 Dec;45(6):447-51.
The authors assessed the potential role of transcranial Doppler ultrasonography (US) in monitoring hemodynamic changes induced by embolization of cerebral arteriovenous malformations. Transcranial Doppler US was performed in eight patients with such lesions before and after embolization with n-butyl cyanoacrylate [corrected]. Changes in mean flow velocity and pulsatility index were analysed in all feeding and nonfeeding arteries. Anatomic and hemodynamic observations were also correlated with the results of digital subtraction angiography. A consistent trend was observed in all treated feeding arteries after embolization: the flow velocity decreased by a mean of 26% or 33 cm/s (p = 0.01, paired t-test), and the pulsatility index increased by a mean of 27% or 0.15 (p = 0.005). Although these changes did not correlate with the degree of angiographic reduction of the nidus (r = -0.31), they were most marked in malformations with a lower Spetzler grade or a higher degree of shunt obliteration. After embolization, recruitment of untreated feeding arteries was documented in two cases and a decrease in the "steal effect" from contralateral nonfeeding arteries in three. Changes in the nonfeeding arteries ipsilateral and contralateral to the malformation were variable. The authors conclude that transcranial Doppler US is a convenient and reliable method to evaluate quantitatively the hemodynamic effects of embolization of cerebral arteriovenous malformations.
作者评估了经颅多普勒超声检查（US）在监测脑动静脉畸形栓塞引起的血流动力学变化中的潜在作用。对8例患有此类病变的患者在使用氰基丙烯酸正丁酯[校正后]栓塞前后进行经颅多普勒超声检查。分析了所有供血动脉和非供血动脉的平均流速和搏动指数的变化。解剖学和血流动力学观察结果也与数字减影血管造影的结果相关。栓塞后在所有治疗的供血动脉中观察到一致的趋势：流速平均降低26%或33 cm/s（p = 0.01，配对t检验），搏动指数平均增加27%或0.15（p = 0.005）。尽管这些变化与病灶血管造影减少的程度无关（r = -0.31），但在Spetzler分级较低或分流闭塞程度较高的畸形中最为明显。栓塞后，2例记录到未治疗供血动脉的募集，3例记录到对侧非供血动脉“盗血效应”的降低。畸形同侧和对侧非供血动脉的变化各不相同。作者得出结论，经颅多普勒超声是一种方便且可靠的方法，可用于定量评估脑动静脉畸形栓塞的血流动力学效应。
