DYNAMIC CEREBRAL AUTOREGULATION ASSESSMENT USING EXTRACRANIAL INTERNAL CAROTID ARTERY DOPPLER ULTRASONOGRAPHY
DYNAMIC CEREBRAL AUTOREGULATION ASSESSMENT USING EXTRACRANIAL INTERNAL CAROTID ARTERY DOPPLER ULTRASONOGRAPHY
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DOI：
10.1016/j.ultrasmedbio.2017.02.003
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发表时间：
2017-07-01
影响因子：
2.9
通讯作者：
Hu, Chaur-Jong
中科院分区：
文献类型：
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作者：
Chi, Nai-Fang;Ku, Hsiao-Lun;Hu, Chaur-Jong
大脑中动脉（MCA）的经颅多普勒超声检查经常用于评估动态脑自动调节（dCA）;然而，这在颞骨窗较差的患者中很难。在这里描述的研究中，我们调查了从颅外颈内动脉（伊卡）和从MCA确定的dCA指数的一致性和灵敏度。对32例中风患者和59例对照者的测量结果进行了分析。同时测量伊卡和大脑中动脉颅外段的平均血流相关指数（Mx）和基于自发性血压波动的传递函数分析。伊卡和MCA之间的Mx和相移的平均值没有显著差异（平均差异：Mx 5 0.01;极低频[VLF]相移5 0.7度，低频[LF]相移5 3.3度，高频相移= 4.5度），但伊卡的VLF和LF增益显著低于MCA（平均差异：VLF增益=-0.13，LF增益= -0.10）。伊卡和MCA的dCA指数之间的类内相关系数在Mx（0.76）和VLF的相移（0.72）中是有利的。脑卒中诊断的受试者工作特征曲线下面积在dCA指标之间没有差异。我们的结论是，从伊卡评估的dCA是有效的，从MCA，但结果是不可互换的。（电子邮件：naifangchi@tmu.edu.tw）（C）2017年世界医学和生物学超声联合会。
Transcranial Doppler ultrasonography of the middle cerebral artery (MCA) is frequently used to assess dynamic cerebral autoregulation (dCA); however, this is difficult in patients with poor temporal bone windows. In the study described here, we investigated the agreement and sensitivity of dCA indices determined from the extracranial internal carotid artery (ICA) and those determined from the MCA. Measurements for 32 stroke patients and 59 controls were analyzed. Measurement of the mean flow correlation index (Mx) and transfer function analysis based on spontaneous blood pressure fluctuation were simultaneously performed for the extracranial ICA and MCA. The mean values of Mx and phase shift did not significantly differ between the ICA and MCA (mean difference: Mx 5 0.01; phase shift of very low frequency [VLF] 5 0.7 degrees, low frequency [LF] 5 3.3 degrees and high frequency = 4.5 degrees), but the gains in VLF and LF in the ICA were significantly lower than those in the MCA (mean difference: gain of VLF = -0.13, gain of LF = -0.10). The intra-class correlation coefficient between the dCA indices of the ICA and MCA was favorable in Mx (0.76) and the phase shift of VLF (0.72). The area under the receiver operating characteristic curve for stroke diagnosis did not differ among the dCA indices. We conclude that dCA assessed from the ICA is as effective as that from the MCA, but the results are not interchangeable. (E-mail: naifangchi@tmu.edu.tw) (C) 2017 World Federation for Ultrasound in Medicine & Biology.