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目的 探讨脑微血管多普勒超声在脑动脉瘤术中的应用价值。方法 应用微血管多普勒超声诊断仪 (Multi Dop ,DWL ,ElektronischeSystemGmbH ,Germany ,探头直径 1mm ,频率 16MHz)对 74例患者共 76个脑动脉瘤及其载瘤动脉和分支 ,在动脉瘤夹安放前、后进行了血流信号、频谱形态和血流速度检测。术后对 37例患者的 38个动脉瘤进行了脑血管造影检查 ,并与术中微血管多普勒超声检测结果对照分析。结果 所有夹闭前的动脉瘤均可测及血流信号并可区分层流和湍流 ,夹闭后的动脉瘤体均未探测到血流信号 ,无音频和频谱显示 ,证实已被完全夹闭 ;而载瘤动脉及其分支和邻近的小动脉、主要穿动脉则可测及血流信号。有 6例 ( 8%)通过重新安放动脉瘤夹而获得校正。术后 37例患者的脑血管造影检查结果与术中微血管多普勒超声检测结果一致。结论 脑微血管多普勒超声是一种能够在术中评价动脉瘤夹闭后闭塞程度、载瘤动脉及其分支的血流动力学改变的微创伤性方法。
Objective To investigate the value of cerebral microvascular Doppler ultrasound in cerebral aneurysm surgery. Methods A total of 76 cerebral aneurysms and their parental artery and branches were obtained from 74 patients with multi-vessel Doppler sonography (Multi Dop, DWL, Elektronische System GmbH, Germany, probe diameter 1 mm, frequency 16 MHz) , After the blood flow signal, spectral morphology and blood flow velocity detection. Thirty-eight aneurysms of 37 patients underwent cerebrovascular angiography after operation and compared with intraoperative findings of microvascular Doppler ultrasound. Results All aneurysms before occlusion were able to detect blood flow signals and to distinguish between laminar flow and turbulent flow. No blood flow signals were detected in the aneurysm after clipping, and no audio or frequency spectrum was found, which confirmed that the aneurysm had been completely clamped Closed; while the parent artery and its branches and adjacent small arteries, the main arteries can be measured and blood flow signal. Six patients (8%) obtained a correction by repositioning the aneurysm clip. The results of cerebrovascular angiography in 37 patients were consistent with those of intraoperative microvascular Doppler ultrasound. Conclusions Cerebral microvascular Doppler ultrasound is a minimally invasive method that can assess the degree of occlusion, the hemodynamic changes of the parent artery and its branches during the procedure.