The Presto 1000: A novel automated transcranial Doppler ultrasound system.
The Presto 1000: A novel automated transcranial Doppler ultrasound system.
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DOI：
10.1016/j.jocn.2015.05.026
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发表时间：
2015-11
期刊：
影响因子：
--
通讯作者：
Lawton MT
中科院分区：
文献类型：
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作者：
Han SJ;Rutledge WC;Englot DJ;Winkler EA;Browne JL;Pflugrath L;Cronsier D;Abla AA;Kliot M;Lawton MT
我们研究了一种新的自动经颅多普勒（TCD）系统的可靠性和易用性相比，传统的TCD系统。TCD超声允许无创监测脑血流，并可预测蛛网膜下腔出血（SAH）后的动脉血管痉挛。Presto 1000 TCD系统（PhysioSonics，Bellevue，WA，USA）设计用于通过颞窗监测大脑中动脉（MCA）M1段的血流。Presto 1000系统在多个临床前和临床环境中与对照同品种TCD系统并行进行测试。在体模流发生装置中，Presto 1000和Spencer系统（Spencer Technologies，雷德蒙，WA，USA）都能够以高精度检测速度。在9名志愿患者中，Presto系统能够在18个颞窗中的14个中定位MCA，平均时间为12.5 s。在5名患者的SAH队列中，共进行了25次成对测量，两种系统测量的M1段流速的平均绝对差为17.5 cm/s。这些数据表明，Presto系统提供了一种自动TCD，可以可靠地定位和检测MCA的流量，相对易于使用。该系统还具有额外的优点，即操作员只需接受最少的培训，并且可以由许多提供者在多个床边环境中使用。生成的平均速度需要在更广泛的患者组中进一步验证，血管痉挛的预测值应根据当前的血管造影标准进行检查。
We examined the reliability and ease of use of a novel automated transcranial Doppler (TCD) system in comparison to a conventional TCD system. TCD ultrasound allows non-invasive monitoring of cerebral blood flow, and can predict arterial vasospasm after a subarachnoid hemorrhage (SAH). The Presto 1000 TCD system (PhysioSonics, Bellevue, WA, USA) is designed for monitoring flow through the M1 segment of the middle cerebral artery (MCA) via temporal windows. The Presto 1000 system was tested across multiple preclinical and clinical settings in parallel with a control predicate TCD system. In a phantom flow generating device, both the Presto 1000 and Spencer system (Spencer Technologies, Redmond, WA, USA) were able to detect velocities with high accuracy. In nine volunteer patients, the Presto system was able to locate the MCA in 14 out of 18 temporal windows, in an average of 12.5 s. In the SAH cohort of five patients with a total of 25 paired measurements, the mean absolute difference in flow velocities of the M1 segment, as measured by the two systems, was 17.5 cm/s. These data suggest that the Presto system offers an automated TCD that can reliably localize and detect flow of the MCA, with relative ease of use. The system carries the additional benefit of requiring minimal training for the operator, and can be used by many providers across multiple bedside settings. The mean velocities that were generated warrant further validation across an extended group of patients, and the predictive value for vasospasm should be checked against the current standard of angiography.