Schöning M, Staab M, Walter J, Niemann G
Division of Neuropediatrics, Children's Hospital of the University, Tübingen, Germany.
Stroke. 1993 Sep;24(9):1305-9. doi: 10.1161/01.str.24.9.1305.
Transcranial color duplex sonographic examinations in children and adolescents without cerebrovascular disease were evaluated retrospectively. Flow velocities and waveform parameters were determined and their side-to-side differences and age dependence analyzed and, finally, compared with analogous data of a previously described group of healthy adults.
With a 2.0-MHz sector transducer of a computed sonographic system, the anterior, middle, and posterior cerebral arteries were examined in 64 children and adolescents between 1.5 and 17.5 years of age. Angle-corrected systolic peak, end-diastolic maximum, time-averaged, and time-averaged maximum velocities, and the resistance, pulsatility, and spectral broadening indexes were determined in all vessels.
Mean +/- SD values for time-averaged maximum velocity (and time-averaged velocity) were 92.2 +/- 13.0, 79.9 +/- 17.7, and 63.9 +/- 13.6 (55.3 +/- 11.7, 40.4 +/- 10.4, and 34.2 +/- 9.2) cm/s, respectively, in the middle, anterior, and posterior cerebral arteries in children under 10 years of age; values were 83.2 +/- 11.9, 69.4 +/- 13.8, and 55.6 +/- 10.1 (50.8 +/- 9.0, 39.9 +/- 10.5, and 33.1 +/- 6.3) cm/s, respectively, in children 10 years of age and older. Time-averaged maximum velocity decreased significantly with age in all vessels (P < .001). Although time-averaged velocity did not change significantly during childhood and adolescence, a clear decline occurred from adolescence to adulthood (P < .0001 in the middle and posterior cerebral arteries; P < .01 in the anterior cerebral artery). The spectral broadening index decreased significantly from childhood to adolescence in the anterior and posterior cerebral arteries (P < .0001). The resistance and pulsatility indexes remained stable throughout childhood.
Transcranial color duplex sonography allows angle-corrected measurements of "true" flow velocities in basal cerebral arteries. Additional determination of time-averaged velocity permits more detailed evaluation of flow characteristics for all age groups. The transcranial color duplex technique may provide deeper insights on normal cerebral perfusion and its disorders.
对无脑血管疾病的儿童及青少年进行经颅彩色双功能超声检查，并进行回顾性评估。测定血流速度和血流波形参数，分析其左右差异及年龄依赖性，最后与先前描述的一组健康成年人的类似数据进行比较。
使用计算机超声系统的2.0兆赫扇形探头，对64名年龄在1.5至17.5岁之间的儿童及青少年的大脑前动脉、大脑中动脉和大脑后动脉进行检查。测定所有血管的角度校正收缩期峰值、舒张末期最大值、时间平均速度、时间平均最大速度以及阻力指数、搏动指数和频谱增宽指数。
10岁以下儿童大脑中动脉、大脑前动脉和大脑后动脉的时间平均最大速度（和时间平均速度）的均值±标准差分别为92.2±13.0、79.9±17.7和63.9±13.6（55.3±11.7、40.4±10.4和34.2±9.2）厘米/秒；10岁及以上儿童的相应值分别为83.2±11.9、69.4±13.8和55.6±10.1（50.8±9.0、39.9±10.5和33.1±6.3）厘米/秒。所有血管的时间平均最大速度均随年龄显著降低（P<.001）。虽然时间平均速度在儿童期和青少年期没有显著变化，但从青少年期到成年期有明显下降（大脑中动脉和大脑后动脉P<.0001；大脑前动脉P<.01）。大脑前动脉和大脑后动脉的频谱增宽指数从儿童期到青少年期显著降低（P<.0001）。阻力指数和搏动指数在整个儿童期保持稳定。
经颅彩色双功能超声检查可对大脑基底动脉的“真实”血流速度进行角度校正测量。额外测定时间平均速度可对所有年龄组的血流特征进行更详细的评估。经颅彩色双功能超声技术可能为正常脑灌注及其紊乱提供更深入的见解。
