Transcranial Doppler and near-infrared spectroscopy can evaluate the hemodynamic effect of carotid artery occlusion
Transcranial Doppler and near-infrared spectroscopy can evaluate the hemodynamic effect of carotid artery occlusion
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DOI：
10.1161/01.str.0000106486.26626.e2
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发表时间：
2004-01-01
期刊：
影响因子：
8.3
通讯作者：
Silvestrini, M
中科院分区：
文献类型：
--
作者：
Vernieri, F;Tibuzzi, F;Silvestrini, M
背景和目的-脑血流动力学和代谢的改变可以补偿颈动脉闭塞性疾病患者脑血流量的减少。目前，一个完整的评估大脑的适应性状态是唯一可能的正电子发射断层扫描。近红外光谱（NIRS）是一种非侵入性的技术，它提供脑血红蛋白波动的真实的时间评估，已被用于估计脑血容量和测量脑血管反应性（VMR）。此外，近红外光谱技术，通过允许绝对测量的吸收和散射系数的大脑，可以确定氧合血红蛋白和脱氧血红蛋白浓度在原位的血流。对27例有症状和无症状的颈动脉闭塞患者和30例健康人进行了经颅多普勒（TCD），能够可靠地检测侧支循环和VMR，以及在静息状态下和CO2反应性试验期间的NIRS。结果-本研究的主要发现是无症状和有症状患者之间的平均流速增加差异的证明经颅多普勒（TCD）和近红外光谱（NIRS）测定的血红蛋白饱和度升高率分别为52.4%和21.0%（P < 0.001（6.8%对3.8%; P = 0.015）。结论-同时进行NIRS和TCD的机会提供了关于闭塞性疾病患者血流动力学和代谢脑适应状态的有用信息，可靠的方式。
Background and Purpose - Cerebral hemodynamic and metabolic changes can compensate for the decrease in cerebral blood flow occurring in patients with carotid occlusive disease. At present, a complete assessment of the cerebral adaptive status is only possible with positron-emission tomography. Near-infrared spectroscopy (NIRS) is a noninvasive technique that, providing a real time assessment of fluctuations in cerebral hemoglobin, has been used to estimate the cerebral blood volume and to measure cerebral vasomotor reactivity (VMR). Moreover, NIRS technology, by allowing the absolute measurement of absorption and scattering coefficients of brain, can determine the oxyhemoglobin and deoxyhemoglobin concentrations in situ in the blood stream.Methods - In order to evaluate different aspects of the cerebral hemodynamic status, 27 subjects with symptomatic and asymptomatic carotid artery occlusion and 30 healthy subjects underwent a simultaneous examination by means of transcranial Doppler (TCD), able to reliably detect collateral circulation and VMR, and NIRS at rest condition and during CO2 reactivity test.Results - The main finding of this study was the demonstration of a difference between asymptomatic and symptomatic patients in terms of mean flow velocity increase (52.4% versus 21.0%; P < 0.001) estimated by TCD and of hemoglobin saturation increase measured by NIRS (6.8% versus 3.8%; P = 0.015).Conclusions - The opportunity to perform NIRS and TCD simultaneously provides useful information about both hemodynamic and metabolic cerebral adaptive status in patients with occlusive disease in a simple, noninvasive, and reliable way.