Clinical cerebrovascular applications of arterial ultrasound volume flow rate estimates
| Autor: | Volker A. Knappertz, Lawrence G. Myers, Charles H. Tegeler |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
Adult
Carotid Artery Diseases Intracranial Arteriovenous Malformations Male medicine.medical_specialty Subarachnoid hemorrhage Ultrasonography Doppler Transcranial medicine.medical_treatment Hemodynamics Subclavian Steal Syndrome medicine.artery Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Common carotid artery Endarterectomy Aged business.industry Ultrasound Arteriovenous malformation Cerebral Arteries Middle Aged medicine.disease Stenosis Cerebrovascular Disorders Vasoconstriction Cardiology Female Neurology (clinical) business Subclavian steal syndrome Blood Flow Velocity |
| Zdroj: | Journal of neuroimaging : official journal of the American Society of Neuroimaging. 6(1) |
| ISSN: | 1051-2284 |
| Popis: | A variety of disorders affect cerebral hemodynamics. Volume flow rate (VFR) estimates now allow accurate quantification of the effect of cerebrovascular lesions on the conduit vessels, with excellent in vivo and in vitro correlation. Four selected cases with VFR data and angiographic correlation are presented to illustrate potential clinical uses of this method. The VFR estimates were obtained with a color M-mode-based velocity imaging technique, which uses time-domain processing (P-700 Color Velocity Imaging System, Philips Ultrasound International, Irvine, CA). In a patient awaiting coronary artery surgery, with unilateral internal carotid artery occlusion and contralateral angiographic stenosis (50-80%, reader variation), the baseline and acetazolamide-challenged common carotid artery VFRs showed excellent conduit function ipsilateral to this stenosis. Thus, the angiographic stenosis did not have significant hemodynamic effects and endarterectomy was avoided. In a patient with an arteriovenous malformation fed by the left vertebral and left external carotid arteries, high in the left cervical region, VFR estimates of two to three times normal predicted the feeding vessels, influenced management, and proved helpful in follow-up. In a patient with subclavian steal syndrome, VFR estimates quantified the steal after brachial hyperemia. Finally, in a patient with delayed vasoconstriction after subarachnoid hemorrhage, very low VFR estimates preceded clinical deterioration. Quantification of hemodynamic changes with VFR estimates was useful for the diagnosis, management, and follow-up of these patients with four types of cerebrovascular disease, and should be applicable in many others. |
| Databáze: | OpenAIRE |
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