経頭蓋カラードプラによる過灌流症候群の早期診断
2004 年 17 巻 2 号 p. 72-75
詳細
2004 年 17 巻 2 号 p. 72-75
The present study was conducted to evaluate the applicability of transcranial color-coded sonography (TCCS) for detection of hemispheric hyperperfusion syndrome after carotid endarterectomy (CEA). This prospective study included 125 consecutive patients who underwent CEA for severe carotid stenosis. TCCS studies were performed serially to evaluate MCA flow velocity before and after CEA. The regional CBF in the MCA territory was evaluated quantitatively before, and 4 and 14 days after CEA using single photon emission computed tomography (SPECT). By TCCS, we detected MCA in 112 (90%) of the 125 patients. Fourteen (13%) of them showed clinical symptoms of hyperperfusion syndrome after CEA. In patients with hyperperfusion syndrome, the affected MCA mean flow velocity ratio (after CEA/before CEA) was higher than that in patients without hyperperfusion (2.14 ±0.45 vs 1.26 ±0.26 times, p<0.001). All 14 patients with hyperperfusion syndrome had a marked change (≥1.5 times) in MCA mean flow velocity at any time point 1 to 4 days after CEA. The ratio of affected MCA mean flow velocity before CEA compared with that 4 days after CEA was significantly correlated with that for rCBF (R=0.44, p<0.0001). TCCS with echo contrast agents is applicable for evaluation of hyperperfusion syndrome after CEA.
