Risk factor analysis of poor transtemporal penetration of ultrasound in TCD examination and evaluation of the detection through transorbital window
RUAN Li-jiang~* XlE Hui-fang HUANG Wei~* WANG Yan~*. * Department of Ultrasound,Xixiang People's Hospital of Shenzhen City,Shenzhen 518102,China
Objective To explore the risk factors of poor transtemporal penetration for ultrasound in transcranial Doppler(TCD)examination and evaluate the possibility of the cerebral blood flow detection through transorbital approach.Methods TCD was performed in 1632 patients via transtemporal window and the data were analyzed;in the ones that had poor transtemporal penetration for ultrasound,cerebral blood flow was detected again through transorbital window.Fifty healthy individuals aged 40-60 years old who had adequate transtemporal and transorbital windows for ultrasound penetration were detected by TCD,and the detected cerebral blood flow were compared between transtemporal and transorbital windows.Results In the 1 632 cases(totally 3 264 temporal windows), the incidence of poor transtemporal penetration was 0.2% in the ones aged40 years,5.5% in the ones aged 40-60 years and 25.8% in the ones aged60 years,respectively;there were significant differences in the incidence among the 3 age groups(P=0.000).The incidence of poor transtemporal penetration in the middle-aged and elderly women was significantly higher than that in the age-matched men(P0.01). In the 304 cases of poor transtemporal penetration,211(69.4%)anterior cerebral arteries(ACA)and 164 (53.9%)middle cerebral arteries(MCA)could be detected by TCD through transorbital window.In the 50 healthy individuals,the blood velocity of ACA detected through transorbital window was not significantly different from that through transtemporal window(P0.05),but the blood velocity of MCA detected through transorbital window was significantly lower than that through transtemporal window, but lower by less than 10% in 48(48%)MCA.Conclusion The incidence of poor transtemporal penetration for ultrasound is related to the age and sex.TCD examination through transorbital window may raise the detection rate.The detection results of ACA blood flow parameters by TCD through transorbital window is reliable,while the results for MCA through transorbital window is relatively reliable and can serve as a reference.
【CateGory Index】： R445.1