Keywords:
Neuroradiology brain, CT, Ultrasound-Colour Doppler, Ultrasound, Imaging sequences, Comparative studies, Diagnostic procedure, Aneurysms, Acute
Authors:
E. Grigorieva, F. Sharifullin, O. Zabavskaya, L. Hamidova, N. Polunina; Moscow/RU
DOI:
10.1594/ecr2013/C-1332
Methods and Materials
We compared TCD and CT data of 84 patients with ruptured cerebral aneurisms at admission,
before and after surgery which were treated in our Institute during the period from 2009 till 2010.
The patients were divided into 3 groups according to CT data: I Group – ischemic changes were identified prior and after operation (24 patients); II Group - ischemic changes detected only in the postoperative period (48 patients); III group - without ischemic changes according to CT (12 patients).
All patients with an acute aneurysmal SAH are monitored for vasospasm with daily TCD studies.
If TCD systolic flow velocities (FVs) are increased conventional CT was performed. The CT protocol for patients with suspected vasospasm includes a noncontrast brain CT according to the following protocol: spiral mode,
collimation 8 or 16 × 1.25 mm; pitch,
1.8; section thickness,
5.0 mm; reconstruction interval,
1.00 mm; acquisition parameters,
120 kVp/240 mA.
TCD FVs were carried out with a unit DWL MULTI-DOP z T (Germany) with the probe 2.4 MHz,
allowing evaluating the cerebral blood flow as in real-time as well as the pulse wave.
FVs were measured in the internal carotid artery bifurcations (ICABs),
anterior cerebral (ACA),
middle cerebral (MCA) and posterior cerebral artery (PCA). Angiospasm was assessed according to systolic linear blood flow velocity in middle cerebral artery with normal values up to 130cm/s.
Angiospasm was moderate at FVs 140-200cm/s,
expressed – at 200-300cm/s,
critical – more than 300cm/s.