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Intracranial arterial duplex Doppler waveform analysis in infants
1Department of Radiology, University of Nebraska Medical Center, Omaha 68105-1065.
Insights
Duplex sonography revealed increased arterial pulsatility in the Circle of Willis for pediatric patients with intracranial hemorrhage and hypoxic-ischemic encephalopathy. This finding aids in diagnosing various pediatric brain conditions using Doppler ultrasound.
Area of Science:
- Pediatric Neurology
- Neuroimaging
- Cerebrovascular Physiology
Background:
- Duplex sonography is a non-invasive neuroimaging technique.
- Assessing cerebral blood flow dynamics is crucial in pediatric neurological conditions.
- Pulsatility of arterial waveforms can indicate cerebrovascular changes.
Purpose of the Study:
- To evaluate the utility of Doppler arterial waveforms from the Circle of Willis in differentiating pediatric brain pathologies.
- To investigate increased pulsatility as a potential biomarker in conditions like intracranial hemorrhage and hypoxic-ischemic encephalopathy.
Main Methods:
- Duplex sonography of the brain was performed on 130 pediatric patients.
- Doppler arterial waveforms from the Circle of Willis were analyzed for pulsatility.
- Patients were categorized into groups: normal, intracranial hemorrhage, hypoxic-ischemic encephalopathy, hydrocephalus with shunt, and ventriculomegaly without shunt.
Main Results:
- Increased pulsatility was observed in 82% of intracranial hemorrhage cases and 53% of hypoxic-ischemic encephalopathy cases.
- Lower rates of increased pulsatility were found in hydrocephalus (31%) and ventriculomegaly (36%) groups.
- Mean pulsatility was significantly increased (p<0.05) across most pathological groups, excluding ventriculomegaly without complications.
Conclusions:
- Doppler sonography of the Circle of Willis demonstrates altered arterial pulsatility in pediatric intracranial hemorrhage and hypoxic-ischemic encephalopathy.
- Increased pulsatility in Doppler waveforms may serve as a valuable indicator in diagnosing specific pediatric neurological conditions.
- The diagnostic efficiency of different pulsatility indices was comparable.
Abstract:
Duplex sonography of the brain was performed on 130 pediatric patients: 53 with normal brains, 22 with intracranial hemorrhage, 15 with hypoxic-ischemic encephalopathy, 29 with hydrocephalus requiring ventricular shunting, and 11 with ventriculomegaly without hemorrhage or shunting. Doppler arterial waveforms from the Circle of Willis showed increased pulsatility in 82% of patients with intracranial hemorrhage, 53% of patients with hypoxic-ischemic change, and in only 31% of patients with hydrocephalus requiring shunt and 36% of patients with ventriculomegaly without shunt or hemorrhage. Mean pulsatility was increased (p less than 0.05) in all groups except ventriculomegaly without hemorrhage or shunt. No statistical difference was found in the diagnostic efficiency of three indices of pulsatility (frequency index profile, pulsatility index, systolic to diastolic ratio).