The Use of Transcutaneous Thermal Convection Analysis to Assess Shunt Function in the Pediatric Population
The Use of Transcutaneous Thermal Convection Analysis to Assess Shunt Function in the Pediatric Population
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DOI：
10.1227/neu.0b013e31823cf18d
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发表时间：
2012-06-01
期刊：
影响因子：
4.8
通讯作者：
Gaskill, Sarah J.
中科院分区：
文献类型：
--
作者：
Marlin, Arthur E.;Gaskill, Sarah J.
背景：分流功能障碍的诊断在很大程度上是由主观的临床病史和评估结合神经诊断成像做出的。目的：评价经皮热对流设备在分流功能障碍诊断中的应用。方法：我们介绍了一种商业设备的试验结果，该设备符合机构审查委员会批准的方案。所有患者都进行了神经诊断研究，确定了他们在经皮热对流测量时的分流功能。对35例患者进行了37次分流的研究。要纳入，患者必须在0到18岁之间，必须在3个月内进行常规随访评估，并必须进行神经诊断成像(计算机断层扫描或磁共振成像)，作为这次访问和分流系列的一部分。所有患者均接受常规随访，无一例出现分流功能障碍的临床症状。结果：3例患者分流管断裂。其余32名患者根据临床标准、计算机断层扫描或磁共振成像扫描，以及在适当的情况下进行分流系列检查，确定有功能分流。在这些剩余的患者中，最初只有40%的患者证实了FLOW。在对数据进行了一些过滤后，这一比例增加到了51%。尽管这些结果令人失望，但它们概述了目前该技术存在的问题及其实用状况，并指出需要进一步完善。结论：我们目前的研究表明，通过热对流分析检测到的脑脊液流动不是儿科人群分流功能的可靠指标。
BACKGROUND: The diagnosis of shunt malfunction is largely made by subjective clinical history and assessment in association with neurodiagnostic imaging.OBJECTIVE: To evaluate the use of a transcutaneous thermal convection device for the diagnosis of shunt malfunction.METHODS: We present the results of a trial of a commercially available device under an Institutional Review Board-approved protocol. All patients had neurodiagnostic studies that defined their shunt function at the time of transcutaneous thermal convection measurement. Thirty-seven shunts were studied in 35 patients. To be included, patients had to be between 0 to 18 years of age, had to be due within a 3-month period for routine follow-up evaluations, and had to have neurodiagnostic imaging (computed tomography or magnetic resonance imaging) as part of this visit and a shunt series. All patients were seen in routine follow-up, and none had clinical symptoms of shunt malfunction.RESULTS: Three patients had fractured shunts. The remaining 32 patients had functioning shunts as determined by clinical criteria, computed tomography or magnetic resonance imaging scans, and, when appropriate, a shunt series. In these remaining patients, flow was initially confirmed in only 40%. After some filtering of the data, this was increased to 51%. Although these results are disappointing, they outline the current issues with the technique and the state of its utility and point to the need for further refinement.CONCLUSION: Our current research suggests that cerebrospinal fluid flow as detected by thermoconvection analysis is not a reliable indicator of shunt function in the pediatric population.