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Middle Cerebral Arterial Flow Changes on Transcranial Color and Spectral Doppler Sonography in Patients With Increased Intracranial Pressure
Author(s) -
Wang Yu,
Duan Yun-You,
Zhou Hai-Yan,
Yuan Li-Jun,
Zhang Li,
Wang Wei,
Li Li-Hong,
Li Liang
Publication year - 2014
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/ultra.33.12.2131
Subject(s) - medicine , middle cerebral artery , transcranial doppler , intracranial pressure , cardiology , hemodynamics , cerebral arteries , blood pressure , anesthesia , ischemia
Objectives Intracranial pressure usually increases after severe brain injury. However, a method for noninvasive evaluation of intracranial pressure is still lacking. The purpose of this study was to explore the potential role of transcranial color Doppler sonography in assessing intracranial pressure by observing the middle cerebral artery blood flow parameters in patients with increased intracranial pressure of varying etiology. Methods The hemodynamic changes in the middle cerebral artery in patients with varying degrees of increased intracranial pressure were investigated by transcranial color Doppler sonography in 93 patients who had emergency surgery for brain injury. Results Middle cerebral artery Doppler flow spectra changed regularly as intracranial pressure increased. The pulsatility index (PI) and resistive index (RI) had a significantly positive correlation with intracranial pressure ( r = 0.90 and 0.89, respectively; P < .001), whereas the middle cerebral artery diastolic velocity showed a significant negative correlation with intracranial pressure ( r = −0.52; P < .01). A receiver operating characteristic curve showed that the RI and PI cutoff values were 0.705 and 1.335, respectively, for predicting increased intracranial pressure, with sensitivity of 0.885 and specificity of 0.970. Conclusions In addition to the PI and RI, middle cerebral artery diastolic flow velocity measurement by transcranial color Doppler sonography may also be a useful variable for evaluating intracranial pressure in patients with acute brain injury.