Transcranial Doppler Velocities in a Large, Healthy Population
Transcranial Doppler Velocities in a Large, Healthy Population
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DOI：
10.1111/j.1552-6569.2012.00711.x
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发表时间：
2013-07-01
影响因子：
2.4
通讯作者：
Evans, Greg
中科院分区：
文献类型：
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作者：
Tegeler, Charles H.;Crutchfield, Kevin;Evans, Greg
经颅多普勒（TCD）超声自1982年Aaslid及其同事首次描述其临床应用以来，已广泛用于脑血管疾病患者的评估和治疗。TCD是一种无痛、安全、无创的诊断技术，可测量各种脑动脉的血流速度。目前，全球有许多商业化的TCD设备被批准使用，TCD被认为对各种临床适应症和环境具有既定的临床价值。尽管许多研究报告了正常值，但最近的研究很少，而且没有一个包括跨年龄、种族和性别的健康受试者的大队列。随着越来越客观、自动化的过程被开发出来，以协助TCD研究的表现和解释，并有可能轻松地将结果与参考人群进行比较，重要的是要定义稳定的正常值和不同年龄、种族和性别的方差，清楚地了解测量的可变性，以及不同解剖节段的产量。方法为了确定健康人群的正常TCD值，我们招募了364名年龄在18-80岁的健康受试者，进行了完整的非影像学TCD检查。排除已知或怀疑有脑血管疾病、有脑血管影响的全身性疾病以及已知有高血压、糖尿病、中风、冠状动脉疾病或心肌梗死的受试者。记录自我报告的种族、惯用手、血压和体重指数。完整的TCD检查由一名经验丰富的超声医师完成，使用单门非成像TCD设备，并采用标准化方案询问多达23个动脉段。保存每个片段的单独多普勒频谱，并使用仪器的自动波形跟踪功能计算速度和脉搏指数（PI）值。进行描述性分析以确定平均速度和PI，并分析所有数据按年龄、性别、种族、利手性、BMI和BP的变化。结果在所有年龄、性别和种族的关键颅内节段中，平均血流速度（MBFV）在MCA最高，在PCA最低。除了M1远端（P = 0.022）和C1远端（P = 0.022）外，威利斯圈左右节段间的mbfv无差异
BACKGROUNDTranscranial Doppler (TCD) ultrasonography has been extensively used in the evaluation and management of patients with cerebrovascular disease since the clinical application was first described in 1982 by Aaslid and colleagues TCD is a painless, safe, and noninvasive diagnostic technique that measures blood flow velocity in various cerebral arteries. Numerous commercially available TCD devices are currently approved for use worldwide, and TCD is recognized to have an established clinical value for a variety of clinical indications and settings. Although many studies have reported normal values, there have been few recently, and none to include a large cohort of healthy subjects across age, race, and gender. As more objective, automated processes are being developed to assist with the performance and interpretation of TCD studies, and with the potential to easily compare results against a reference population, it is important to define stable normal values and variances across age, race, and gender, with clear understanding of variability of the measurements, as well as the yield from various anatomic segments.METHODSTo define normal TCD values in a healthy population, we enrolled 364 healthy subjects, ages 18-80 years, to have a complete, nonimaging TCD examination. Subjects with known or suspected cerebrovascular disorders, systemic disorders with cerebrovascular effects, as well as those with known hypertension, diabetes, stroke, coronary artery disease, or myocardial infarction, were excluded. Self-reported ethnicity, handedness, BP, and BMI were recorded. A complete TCD examination was performed by a single experienced sonographer, using a single gate nonimaging TCD device, and a standardized protocol to interrogate up to 23 arterial segments. Individual Doppler spectra were saved for each segment, with velocity and pulsatility index (PI) values calculated using the instrument's automated waveform tracking function. Descriptive analysis was done to determine the mean velocities and PI, and all data were analyzed for changes by decade of age, sex race, handedness, BMI, and BP.RESULTSAmong the key intracranial segments, mean blood flow velocities (MBFV) were highest in the MCA and lowest in the PCA across all ages, sexes, and ethnic groups. There was no difference in the MBFVs between left and right side segments of the Circle of Willis, with the exception of the distal M1 (P = .022) and the C1 (P