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【文摘发布】经颅多普勒和椎基底动脉记录诊断
Author：Del Sette M, Dinia L, Rizzi D, Sugo A, Albano B, Gandolfo C.
From the Department of Neurosciences, Ophthalmology, and Genetics, University of Genova, Genova, Italy.
Resource: Stroke. 2007 Jun 28; [Epub ahead of print]
Abstract：BACKGROUND AND PURPOSE: Right-to-left shunt (RLS) due to patent foramen ovale is a well-established risk factor for cryptogenic stroke and is highly prevalent in cases of migraine, cluster headache, and obstructive apnea. It can be diagnosed by gaseous-contrast transcranial Doppler, yet in a small percentage of cases it cannot be done owing to an insufficient temporal window. The aim of the study was to compare transtemporal with transoccipital approaches for gaseous-contrast transcranial Doppler for RLS diagnosis. METHODS: We evaluated 183 subjects with a standard protocol for RLS diagnosis by simultaneously monitoring the right middle cerebral and vertebrobasilar circulations. RESULTS: Vertebrobasilar recording reached high specificity (100%) and good sensitivity (83.72%) for the diagnosis of RLS after the Valsalva maneuver. For only medium and large shunts, both sensitivity and specificity reached 100%. Time to bubble appearance after injection was higher in the vertebrobasilar circulation (4.36+/-1.7 vs 6.77+/-2.5 seconds; P<0.001). There was a positive correlation between the number of bubbles in the right middle cerebral and vertebrobasilar circulation (kappa=0.97). CONCLUSIONS: Transcranial Doppler with vertebrobasilar monitoring is highly sensitive and specific in detecting RLS, particularly when medium or large. It can be proposed for subjects with an insufficient temporal bone window.
PMID: 17600238 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Title：Diagnosis of Right-to-Left Shunt With Transcranial Doppler and Vertebrobasilar
Recording.
经颅多普勒和椎基底动脉记录诊断右向左分流
Author：Del Sette M, Dinia L, Rizzi D, Sugo A, Albano B, Gandolfo C.
From the Department of Neurosciences, Ophthalmology, and Genetics, University of Genova,
Genova, Italy.
Resource: Stroke. 2007 Jun 28; [Epub ahead of print]
Abstract： BACKGROUND AND PURPOSE: Right-to-left shunt (RLS) due to patent foramen ovale is
a well-established risk factor for cryptogenic stroke and is highly prevalent in cases of
migraine, cluster headache, and obstructive apnea. It can be diagnosed by gaseous-contrast
transcranial Doppler, yet in a small percentage of cases it cannot be done owing to an
insufficient temporal window. The aim of the study was to compare transtemporal with
transoccipital approaches for gaseous-contrast transcranial Doppler for RLS diagnosis.
摘要：背景和目的：众所周知，卵圆孔未闭所致的右向左分流是病因不明的卒中的危险因子，并且与偏头
痛、丛集性头痛、阻塞性呼吸暂停等密切相关。卵圆孔未闭可以通过气相对照经颅多普勒诊断出来，然而
有部分病例由于颞窗不充分而无法诊断。本项研究的目的在于对比经颅多普勒经颞叶的与经枕部入路对
RLS诊断的差别。
METHODS: We evaluated 183 subjects with a standard protocol for RLS diagnosis by
simultaneously monitoring the right middle cerebral and vertebrobasilar circulations.
方法：通过对183例患者进行右侧大脑中动脉和椎基底动脉环的同步检测来评价其对RLS诊断标准。
RESULTS: Vertebrobasilar recording reached high specificity (100%) and good sensitivity
(83.72%) for the diagnosis of RLS after the Valsalva maneuver. For only medium and large
shunts, both sensitivity and specificity reached 100%. Time to bubble appearance after
injection was higher in the vertebrobasilar circulation (4.36+/-1.7 vs 6.77+/-2.5 seconds;
P<0.001). There was a positive correlation between the number of bubbles in the right middle
cerebral and vertebrobasilar circulation (kappa=0.97).
结果：Valsalva动作后，椎基底报告对RLS的诊断达到高特异性（100％）和高敏感性（83.72％），对仅
有中等和严重分流的患者敏感性和特异性均达到了100％。椎基底动脉环组注射后到微泡出现的时间显著
延长(4.36+/-1.7 vs 6.77+/-2.5 seconds; P<0.001)。右侧大脑中动脉与椎基底动脉环的微泡数之间呈
正相关(kappa=0.97)。
CONCLUSIONS: Transcranial Doppler with vertebrobasilar monitoring is highly sensitive and
specific in detecting RLS, particularly when medium or large. It can be proposed for
subjects with an insufficient temporal bone window.
结论：经颅多普勒行椎基底动脉监测在检测RLS方面有高敏感性和特异性，尤其对中等或严重分流的者。
PMID: 17600238
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作者:admin@医学,生命科学 2011-03-13 17:12
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