Bailes J E, Tantuwaya L S, Fukushima T, Schurman G W, Davis D
Department of Neurological Surgery, Allegheny Neuroscience Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA.
Neurosurgery. 1997 May;40(5):965-70; discussion 970-2. doi: 10.1097/00006123-199705000-00018.
The goal was to evaluate the efficacy and reliability of intraoperative microvascular doppler sonography for the assessment of cerebral hemodynamics in aneurysm surgery.
For 35 patients who underwent surgery for the treatment of 42 intracranial aneurysms, microvascular doppler sonography with a 20-MHz probe (1-mm diameter) was used before and after clip application, to confirm the obliteration of aneurysms. Assessment of the patency of the parent vessels and all branching arteries was performed. The findings from doppler sonography were confirmed with either intraoperative angiography or immediate postoperative angiography.
The 1-mm microprobe was able to insonate all vessels of the circle of Willis and their major branches; furthermore, perforating arteries were reliably insonated. For 11 patients (31%), doppler sonography exposed parent artery or branching artery stenosis or occlusion and guided the immediate adjustment of aneurysm clip placement. The findings from intraoperative microvascular doppler sonography correlated with findings from angiography in all cases. There were no complications of microvascular doppler probe use.
Intraoperative microvascular doppler sonography is a safe, instantaneous, effective, reliable, and cost-effective method for documenting the patency of parent vessels, arterial branches, and major perforators and the complete occlusion of cerebral aneurysms. This technique can be reliably used, in many instances, instead of intraoperative angiography for the surgical treatment of aneurysms.
评估术中微血管多普勒超声在颅内动脉瘤手术中评估脑血流动力学的有效性和可靠性。
对35例接受手术治疗42个颅内动脉瘤的患者，在夹闭动脉瘤前后使用20兆赫探头（直径1毫米）的微血管多普勒超声，以确认动脉瘤闭塞情况。对载瘤血管和所有分支动脉的通畅情况进行评估。多普勒超声检查结果通过术中血管造影或术后即刻血管造影进行确认。
1毫米的微型探头能够探测到 Willis 环的所有血管及其主要分支；此外，还能可靠地探测到穿支动脉。对于11例患者（31%），多普勒超声检查发现载瘤动脉或分支动脉狭窄或闭塞，并指导了动脉瘤夹位置的即刻调整。术中微血管多普勒超声检查结果在所有病例中均与血管造影结果相关。使用微血管多普勒探头未出现并发症。
术中微血管多普勒超声是一种安全、即时、有效、可靠且经济高效的方法，可用于记录载瘤血管、动脉分支和主要穿支的通畅情况以及脑动脉瘤的完全闭塞情况。在许多情况下，该技术可可靠地替代术中血管造影用于动脉瘤的手术治疗。
