Acetazolamide vasoreactivity evaluated by transcranial harmonic perfusion imaging: relationship with transcranial Doppler sonography and dynamic CT.
Acetazolamide vasoreactivity evaluated by transcranial harmonic perfusion imaging: relationship with transcranial Doppler sonography and dynamic CT.
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通过经颅谐波灌注成像评估乙酰唑胺血管反应性：与经颅多普勒超声检查和动态 CT 的关系。
DOI：
10.1007/978-3-7091-0651-8_13
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Hiroshi Furuhata
中科院分区：
文献类型：
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作者：
Toshiyuki Shiogai;M. Koshimura;Y. Murata;H. Nomura;A. Doi;Masahiro Makino;Toshiki Mizuno;Kenji Nakajima;Hiroshi Furuhata
为探讨经颅超声谐波灌注成像（HPI）的可靠性和临床意义，我们在乙酰唑胺（ACZ）血管反应性试验中，评价了HPI与经颅多普勒（TCD）和动态CT（DCT）的关系。受试者为12名神经系统患者。用TCD测量大脑中动脉（MCA）和大脑后动脉的时间平均最大血流速度（TAVMX）。在轴向平面上涉及两侧颞叶、基底神经节和丘脑的3个感兴趣区域（ROI）中创建了静脉推注对比剂后HPI（DCT）的时间-强度（-密度）曲线。根据ACZ给药前后的比较评估血管反应性：a）TCD TAVMX的相对变化（%Δ），B）HPI对比面积扩大，c）计算的脑血容量和HPI和DCT流量的%Δ。1)左侧MCA的TCD血管反应性降低与左侧HPI对侧区扩大的频率较低相关。2)HPI和DCT血管反应性在同侧ROI中有紊乱的趋势。经颅HPI通过对脑组织灌注的定性和定量测量，实现了对脑血管储备能力的可重复无创床旁评价，在神经重症监护患者的病理生理随访和疗效判定方面具有临床价值。
To establish the reliability and clinical significance of transcranial ultrasonic harmonic perfusion imaging (HPI), we evaluated HPI’s relationships with transcranial Doppler (TCD) and with dynamic CT (DCT), during acetazolamide (ACZ) vasoreactivity tests.Methods. The subjects were 12 neurological patients. Time-averaged maximum velocity (TAVMX) in the middle (MCA) and posterior cerebral arteries was measured by TCD. Time-intensity (-density) curves of HPI (DCT) after bolus intravenous contrast injections were created in 3 regions of interest (ROI) on the axial plane involving the temporal lobe, basal ganglia, and thalamus on both sides. Assessments of vasoreactivity were based on comparisons conducted before and after ACZ administra tion in terms of: a) relative changes (%Δ) of the TCD TAVMX, b) HPI contrast area enlargement, c) %Δ of calculated cerebral blood volume and flow of the HPI and DCT.Results. 1) TCD vasoreactivity decrease in the left MCA tended to correlate with lower frequency of HPI contra st area enlargement on the left side. 2) HPI and DCT vasoreactivity tended to be disturbed in the same side ROIs.Conclusions. Transcranial HPI achieves repeatable non-invasive bedside evaluation of cerebrovascular reserve capacity through qualitative and quantitative measurements of brain tissue perfusion, and will have clinical value in pathophysiological follow-up and therapeutic effectiveness determination of neurointensive care patients.