具有角度校正的跨色编码超声波作为查工具,用于提高内压力
Venkatakrishna Rajajee1,2,3, Reza Soroushmehr3,4,5, Craig A Williamson1,2,3
1Department of Neurosurgery, University of Michigan, Ann Arbor, MI.
Critical care explorations
|August 30, 2023
概括
角度校正显著提高了检测高内压力 (ICP) 的跨色编码超声波 (TCCS) 精度. 虽然敏感度很高,但特异性仍然很低,这表明TCCS是ICP的有用选工具.
科学领域:
- 神经临界护理是指神经临界护理.
- 神经声学是一种神经声学.
- 内压力监测 内压力监测
背景情况:
- 跨骨多普勒 (TCD) 是一种用于评估内压力 (ICP) 的非侵入性工具.
- 声波角度错误可能会影响TCD的准确性.
- 之前没有报道过使用跨色编码超声波 (TCCS) 进行ICP评估的角度校正.
研究的目的:
- 评估TCCS的诊断准确性,以检测升高的ICP.
- 评估对TCCS在ICP测量中的准确性对声响角度校正的影响.
主要方法:
- 在一个学术神经临床护理单位进行前性诊断准确性研究.
- 包括连续的成年患者与侵入性ICP监测.
- 使用TCCS测量中脑动脉的速度 (EDV,TAPV) 和脉动率指数 (PI),有或没有角度校正.
主要成果:
- 角度校正改善了估计的ICP (ICPe) 曲线下的面积 (AUC) 从0.51到0.73.
- 经过角度校正,ICPe>21mmHg显示出100%的灵敏度和30%的特异性,ICP>22mmHg显示出100%的灵敏度和30%的特异性.
- 对于PI的AUC也随着角度校正 (0.61到0.70) 得到改善.
结论:
- 声波角校正可以提高TCCS检测升高ICP的准确性.
- 具有角度校正的TCCS显示出高灵敏度,适合ICP选.
- 特异性仍然很低,需要进一步调查或补充诊断方法.
相关概念视频
01:14Increased Intracranial Pressure l: Introduction
Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
01:29Increased Intracranial Pressure ll: Pathophysiology
Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...