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[Value of cerebrovascular hemodynamics analysis on diagnosis of cerebral microcirculation disorder]
1Department of Neurology, Peking University People's Hospital, Beijing 100044, China.
Insights
Cerebrovascular hemodynamics analysis (CVA) offers valuable insights into cerebral microcirculation, aiding in the diagnosis and treatment monitoring of cerebrovascular diseases. This method provides crucial information beyond standard transcranial Doppler (TCD) assessments.
Area of Science:
- Neurology
- Medical Imaging
- Cardiovascular Research
Background:
- Cerebral microcirculation plays a vital role in brain health.
- Assessing microcirculation is crucial for diagnosing and managing cerebrovascular diseases.
- Traditional methods like transcranial Doppler (TCD) have limitations in evaluating the microvascular bed.
Purpose of the Study:
- To evaluate the clinical utility of cerebrovascular hemodynamics analysis (CVA) in assessing cerebral microcirculation.
- To determine if CVA provides information not obtainable through TCD.
- To assess CVA's role in diagnosis and treatment monitoring for cerebrovascular disorders.
Main Methods:
- 100 patients with ischemic cerebrovascular disease and abnormal CVA (normal TCD) were studied.
- Patients were categorized into mild, moderate, and severe subgroups based on hemodynamic parameters.
- Key CVA parameters (Vmin, Qmin, R, CCP, CVR) were measured before and after treatment and statistically analyzed.
Main Results:
- Abnormal CVA findings were present in all 100 patients, with 52 showing bilateral and 48 unilateral changes.
- Significant improvements in minimum flow velocity (Vmin) and minimum flow volume (Qmin) were observed post-treatment (96.8% and 96.6% respectively).
- CVA parameters like peripheral resistance (R) and critical closing pressure (CCP) also showed significant improvements, indicating treatment efficacy.
Conclusions:
- CVA is a valuable tool for assessing cerebral microcirculation and intracranial microvascular function.
- CVA complements TCD by providing detailed microcirculatory information.
- CVA aids in diagnosis, treatment monitoring, and localization of cerebrovascular impairments.
Objective:
To determine the clinical value of cerebrovascular hemodynamics analysis (CVA) on cerebral microcirculation.
Methods:
One hundred consecutive patients from neurological department of Peking University People's Hospital from April to October, 2015, with symptoms of dizziness, lightheadedness, headache etc., who were diagnosed with ischemic cerebrovascular disease with normal transcranial doppler (TCD) and abnormal CVA, were recruited in this study.Other medical conditions were excluded through clinic and imaging examinations among these patients.Patients were categorized into mild, moderate and severe subgroups based on the degrees of decreased blood flow velocity and/or volume, and received treatment accordingly.CVA parameters including the minimum flow velocity (Vmin), the minimum flow volume (Qmin), peripheral resistance (R), critical pressure (CCP) and dynamic resistance (CVR) etc.before and after treatment were compared statistically (t test).
Results:
Out of the 100 patients with abnormal CVA, 52 patients had bilateral changes and 48 patients had unilateral changes.The minimum flow velocity and the minimum flow volume anomalies were found in 100 and 92 cases, respectively.A total of 47, 32 and 21 patients had mild, moderate and severe abnormal changes, respectively.Out of the 63 patients who had follow-up CVA after treatment (drop-out 37 cases), there were 63 abnormal Vmin cases, 60 abnormal Qmin cases, 17 abnormal R cases, 18 abnormal CCP cases, 41 abnormal characteristic impedance (Zc) cases, 41 abnormal elastic wave velocity (Wv) cases, 23 abnormal vascular compliance (C) cases, all before treatment.After treatment, symptoms and Vmin synchronization improved in 61 cases (96.8%), Qmin improved in 58 cases (96.6%), R improved in 13 cases (76.5%), CCP improved in 10 cases (55.6%), Zc improved in 27 cases (65.8%), Wv improved in 25 cases (61.0%), C improved in 6 cases (26.1%). All improvements were statistically significant (P<0.05), with Vmin, Qmin, R and CCP showing most significant changes (P<0.000 1). The CVR treatment showed no significant before and after treatment (P>0.05).
Conclusions:
CVA is an important method in assessing cerebral microcirculation perfusion, providing information on intracranial microvascular bed that cannot be detected by TCD.It is not only helpful for diagnosis, but also evaluable for monitoring clinical treatment of cerebral microcirculation disorder.CVA is also helpful in determining the location of cerebral circulation impairment by correlation with carotid ultrasound and TCD.
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