在静脉鼻支架中实时绘制血液动力学变化,使用手术期间的跨骨多普勒超声波和定量血管学
Albert Q Wu1, Rebecca Gitlevich2, Chandrasekhar Palepu3
11Departments of Neurosurgery and.
Neurosurgical focus
|January 22, 2026
概括
跨骨多普勒 (TCD) 超声波显示,静脉鼻腔支架 (VSS) 静脉病性内高血压 (HIV) 后,大脑血流持续增加. 定量血管造影显示出可变的结果,这表明TCD是监测治疗有效性的更可靠工具.
科学领域:
- 神经学 神经学
- 血管外科 血管外科
- 医疗成像医学成像
背景情况:
- 静脉性内高血压 (VIH) 涉及由于静脉鼻狭窄而导致的内压力升高.
- 静脉鼻腔支架 (VSS) 是一种治疗选择,但患者选择和反应评估的生理生物标志物有限.
- 在手术期间需要监测工具来评估VSS期间的血液动力学变化.
研究的目的:
- 评估手术期间的跨骨多普勒 (TCD) 超声波和定量血管造影,以检测HIV患者在VSS期间的大脑血液动力学变化.
- 评估这些成像方法在指导患者选择和评估治疗反应方面的有用性.
主要方法:
- 对11名接受VSS的HIV患者进行了回顾性分析,并进行了手术内TCD和定量血管造影.
- 在支架之前和之后,TCD测量了中脑动脉 (MCAs) 中的平均流速 (MFV) 和脉动率指数 (PI).
- 定量血管造影评估的时间到峰值 (TTP) 的对比度模糊在内动脉 (ICA),前脑动脉 (ACA) 和MCA在一个小组的患者.
主要成果:
- 在VSS后,所有患者都显示MCA平均流速 (MFV) 增加 (p <0.05).
- 脉动性指数 (PI) 呈现下降趋势,但没有达到统计学意义.
- 定量血管造影揭示了异质的时间到峰值 (TTP) 变化,与TCD相比,结果不那么一致.
结论:
- TCD显示动脉输入血动力学的持续增加,这表明其对HIV实时评估的稳定性.
- 定量血管造影显示了可变的动脉过渡变化,可能受到成像条件的限制.
- TCD和定量血管造影是有希望的低风险工具,用于监测和改进HIV的VSS中的患者选择.
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