Guo H H, Pan Y H, Zhou L F, Shi Y Q
Institute of Neurology, Shanghai Medical University.
Chin Med J (Engl). 1993 May;106(5):351-6.
Combined extracranial and transcranial Doppler (TCD) instruments were used to study the hemodynamics of 20 patients with cerebral arteriovenous malformation (AVM) proved angiographically. It was discovered that the flow velocities in AVM-feeding arteries and their proximal arteries were increased; the increase of flow velocities in feeding arteries close to AVM was more remarkable than that in feeding-arteries proximal to extracranial internal carotid artery far from AVM; pulsating indexes of AVM-feeding arteries were decreased; increase of flow velocities in AVM-feeding arteries was related to the decrease of pulsating index; the flow velocities of nontapering feeding arteries were faster than those of tapering arteries; the greater the size of AVM, the faster the velocity in feeding artery; and the flow velocities and pulsating indexes of AVM-feeding arteries were gradually recovered to normal 3-5 weeks after resection of AVM. It is believed that increase of flow velocity in AVM-feeding artery is associated with distention and decreased resistance of flow in AVM-feeding artery. TCD combined with CT scans are helpful to the diagnosis of AVM. Combination of TCD and cerebral angiography (CAG) to evaluate comprehensively the preoperative hemodynamics of AVM and to monitor postoperative changes is helpful to detecting cerebral steal due to steal leakage in circle of Willis and preventing the hazardous postoperative complications caused by pressure breakthrough of normal perfusion.
采用颅外和经颅多普勒（TCD）联合仪器，对20例经血管造影证实的脑动静脉畸形（AVM）患者的血流动力学进行了研究。发现AVM供血动脉及其近端动脉的血流速度增加；靠近AVM的供血动脉血流速度的增加比远离AVM的颅外颈内动脉近端供血动脉更为显著；AVM供血动脉的搏动指数降低；AVM供血动脉血流速度的增加与搏动指数的降低有关；无逐渐变细的供血动脉的血流速度比逐渐变细的动脉更快；AVM越大，供血动脉中的血流速度越快；AVM供血动脉的血流速度和搏动指数在AVM切除后3 - 5周逐渐恢复正常。据信，AVM供血动脉血流速度的增加与AVM供血动脉的扩张和血流阻力降低有关。TCD联合CT扫描有助于AVM的诊断。TCD与脑血管造影（CAG）相结合，全面评估AVM术前的血流动力学并监测术后变化，有助于检测由于 Willis 环盗血渗漏导致的脑盗血，并预防正常灌注压突破引起的危险术后并发症。
