SHEN Huiying, SHENG Xiaojie, KE Qiaohang, et al. Value of transcranial Doppler in predicting intracranial hypertension after craniocerebral injury. [J]. Journal of Clinical Ultrasound in Medicine 23(2):105-109(2021)
SHEN Huiying, SHENG Xiaojie, KE Qiaohang, et al. Value of transcranial Doppler in predicting intracranial hypertension after craniocerebral injury. [J]. Journal of Clinical Ultrasound in Medicine 23(2):105-109(2021) DOI: 10.16245/j.cnki.issn1008-6978.2021.02.010.
Value of transcranial Doppler in predicting intracranial hypertension after craniocerebral injury
Objective To explore the value of transcranial Doppler(TCD) hemodynamic parameters in predicting intracranial hypertension(ICH) after craniocerebral injury.Methods A total of 122 patients with craniocerebral injury were prospectively enrolled and received TCD monitoring once a day for up to 7 d.The test would be stopped if the patients showed decompensation.According to the presence of ICH
patients were divided into ICH group(n=35) and non-ICH group(n=87).The peak systolic velocity(Vs)
end diastolic velocity(Vd)
mean velocity(Vm)
pulsatility index(PI)
and resistance index(RI) of middle cerebral artery(MCA) were recorded.The maximum and mean values of each parameter ΔVs
Max
and ΔV
Mean
ΔVd
Max
andΔVd
Mean
△Vm
Max
and △Vm
Mean
ΔRI
Mean
and ΔRI
Max
ΔPI
Mean
and ΔPI
Max
were calculated and compared.The trend of MCA hemodynamic parameters over time was analyzed.COX regression analysis was used to screen independent predictors for the risk of ICH
and the ROC curve was drawn to analyze the diagnostic efficacy in identifying ICH.Results The MCA hemodynamic parameters(Vs
Vm
and Vd) of patients in the non-ICH group showed a downward trend during the monitoring time
while RI and PI showed an upward trend.Compared with the non-ICH group
the ΔPI
Max
value in the ICH group was increased(P=0.014).COX regression analysis indicated that ΔPI
Max
was an independent predictor of ICH(HR=1.710
P=0.027).ROC curve analysis indicated that ΔPI
Max
was a good indicator for identifying ICH(AUC=0.904)
cut-off value was 0.148
the sensitivity and specificity were 80.00% and 90.80%
respectively.Conclusion ΔPI
Max
of MCA can accurately identify ICH
and is hope to be used as a new indicator to predict ICH.
关键词
超声检查多普勒彩色经颅血流动力学参数颅脑损伤颅内压失代偿期
Keywords
UltrasonographyDopplercolortranscranialHemodynamic parametersCraniocerebral injuryIntracranial pressureDecompensated period
Application value of ultrasoundmeasuredoptic nerve sheath diameter combined with flash visual evoked potential in evaluating intracranial pressure of patients with craniocerebral injury