Method for determining internal carotid artery tone
SUBSTANCE: method involves carrying out ultrasonic examination of the internal carotid artery on neck in M-mode. Coefficient value is calculated as ratio of pulse wave anacrotism to general pulse wavelength. The calculated value being equal to 0.49±0.03 and lower, the tone is evaluated as high one.
EFFECT: high accuracy and informative validity of estimate.
2 dwg, 3 tbl
The invention relates to medicine, namely vascular neurosurgery and angioneurology, and can be used in the evaluation of the disease, determining the stage of the pathological process, and to assess the effectiveness of the treatment.
The development of most of intravascular lesions begins with changes in the functional state of the vascular wall, vascular tone. By definition, vascular tone is the degree of tension of the muscle cells of the vascular wall at this time.
There is a method of assessing vascular tone by ophthalmodynamometry (Mchedlishvili GI Study of cerebral circulation //Methods of clinical neurophysiology. Leningrad, 1977, s-161). The ophthalmic artery is a branch of the internal carotid artery, consequently, changes in intraocular pulsations may indirectly reflect the state of blood flow through these arteries. The common properties of the vascular regions of the brain and eyes also allows you to indirectly judge the state of the tone of cerebral vessels by visual estimation of blood vessels of the ocular fundus. However, the method is not sufficiently informative.
There is a method of assessing vascular tone by rheoencephalography (REG) (Mintz YA, Ronkin M.A. Eographically diagnosis of vascular diseases of the brain //Kiev, "Health", 1967, p.5-40), the cat is who gives the possibility to indirectly estimate the change in the tone of the arteries of the brain by measuring the time interval between the beginning of the wave REG and R-wave of the ECG, since the velocity of propagation of pulse waves in arteries depends on their tone. However, due to the fact that with the reduced caliber of the vessels of the velocity of propagation of pulse wave decreases, the error introduced due to such changes trunk and large PIAL arteries of the brain high. Furthermore, the method is insufficiently informative.
There is a method of indirect assessment of vascular tone by linear blood flow parameters (Leliuk VG, Leliuk SA Ultrasonic diagnosis //Real Time, Moscow, 2003, pp.86-87). During this acceleration time (at-acceleration time) and the index acceleration (AT-acceleration index) indirectly characterize the tone of the vascular wall. However, the method is inaccurate because it does not give sufficient information.
Closest to the claimed method is the evaluation of vascular tone carotid artery (Gaman S.A., Balakhonova T.V., V.E. Sinitsyn, Atkov O.Y Elasticity of the carotid arteries in patients with carotid atherosclerosis and coronary heart disease //4-th Congress of the Russian Association of specialists in ultrasound diagnostics in medicine, Moscow, 27-30 October, 2003, p.95) by study viscoelastic properties of the arterial wall, adopted for the prototype. When this is carried ultrasound of the common carotid artery on the neck in M-mode. Appreciate the difference artery diameter in systole and diastole and Rasch is primarily the young's modulus, the coefficient of diametrical expansion vessel and a coefficient characterizing the dependence of the stress-strain of the vessel wall.
The disadvantage of the prototype is the lack of accurate and informative way, since the degree of expansion of the artery depends not only on the tone, but also on the value of cardiac output.
The invention is directed to a method of assessing vascular tone of the internal carotid arteries, providing increased accuracy and informative way due to the leveling influence of cardiac output.
This technical result in the implementation of the invention is achieved in that in the known method of assessing vascular tone of the internal carotid artery, including ultrasound of the carotid artery in the neck in M-mode, the feature is that I expect the coefficient equal to the ratio of anekdoty pulse wave to the total length of the pulse wave, and when the value of the calculated coefficient of 0.53±0.03 and higher tone is assessed as normal, and a value of 0.49+0.03 and below the tone is assessed as high.
The method is as follows. The patient produce a standard ultrasound examination of the internal carotid artery in the neck with the affected side in M-mode, hold the location of the internal carotid artery at 1.5 cm - 2 cm above before the AI of the common carotid artery with the direction of the scanning plane is strictly perpendicular to the longitudinal axis of the artery. Obtained in the M-mode image is a wave-like oscillation of the arteries over time (on the scale of the abscissa is time, therefore, the length of the oscillations is the time interval). Measure the total length (time) of the pulse wave and the length (time) anocracy (the descending part of the pulse wave). Then calculate the coefficient (KS), is equal to the ratio of the length (time) of anekdoty pulse wave to the total length (time) of the pulse wave. When the value of the calculated coefficient (COP)equal to 0.53±0.03 and higher tone is assessed as normal, and a value of 0.49±0.03 and below, the tone is assessed as high. To improve the accuracy of the result, you can measure the length of the pulse wave and the length of anekdoty several times, and then calculate the arithmetic mean.
The inventive method is developed and clinically tested in the Polenov research neurosurgical Institute them. Professor and Operated in the examination of 10 patients with stenosing lesions of the arteries and 30 healthy volunteers, aged from 25 to 30 years old, without bad habits, without concomitant somatic pathology. Survey volunteers was performed to confirm the accepted norms of the indices: index ripple, the length of the pulse wave, the length of anocracy, factor (COP), which characterizes the ratio of the length of anocracy to the length of the pulse wave inside from the Noah artery.
The figures obtained are processed statistically and are summarized in table 1.
The reliability of the difference between groups was proved by T-criterion with p=0,00576327.
These same persons, calculated the parameters specified in the method prototype. The reliability of the difference between the groups in this case was obtained only at the level of a trend (p=0,1119804).
Thus, the inventive method is more accurate for the assessment of vascular tone artery (p=0,00576327 the proposed method, p=0,1119804 of the prototype method).
Given the following examples:
Example 1. Patient M., 55 years old, and a/b No. 2215-2003. Cerebral atherosclerosis. Hypertension 2 tbsp. Repeated acute disorders of cerebral circulation but ischemic type in the pool of the left internal carotid artery from the 2002, 2003
According to the claimed method for assessing vascular tone of the internal carotid artery of the patient was performed ultrasound HV the internal carotid artery in the neck, on the affected side in M-mode. The resulting graphic image of the oscillations of the arterial wall in time is presented in figure 1. Quantify performance. The indicators are summarized in table 2.
|Length anekdoty||240 ms|
|The length of the pulse wave||507 ms|
|KS anocracy to pulse wave||0,473|
The resulting coefficient (KC)=0,473 that below 0,49, so the tone was assessed as high.
Example 2. Healthy volunteer P., 25 years old, without bad habits and without concomitant somatic pathology. According to the claimed method for assessing vascular tone of the internal carotid artery of the patient was performed ultrasound of the internal carotid artery in the neck in M-mode. The resulting graphic image of the oscillations of the arterial wall in time are presented in figure 2. Quantify performance. The indicators are summarized in table 3.
|Length anekdoty||263 ms|
|The length of the pulse wave||503 ms|
|KS anocracy to pulse wave||0,523|
The resulting coefficient is ecient (KS)=0,523, above 0,53-0,03, so the tone was assessed as normal.
Using the proposed method allows for precise, informative and non-invasive to assess the condition of the vascular tone of the internal carotid artery.
The method of assessing vascular tone of the internal carotid artery, including ultrasound of the carotid artery in the neck in M-mode, wherein the calculated ratio, the ratio of anekdoty pulse wave to the total length of the pulse wave, and when the value of the calculated coefficient of 0.49±0.03 and below the tone is assessed as high.
SUBSTANCE: method involves applying ultrasonic triplex scanning in color Doppler mapping with linear multiple frequency transducer of 5-7-10 MHz being used. Longitudinal cross-section of the posterior tibial artery is produced from direct projection. Its diameter and intima-media complex thickness are measured. Doppler frequency shift spectrum is determined and resistance index is calculated. Tibial artery diameter being reduced by 0.16 cm or less, intima-media complex thickness being normal from 0.01 to 0.04 cm and resistance index being reduced less than 1,0, posterior tibial artery hypoplasia is to be diagnosed.
EFFECT: improved diagnosis quality.
SUBSTANCE: method involves carrying out two-dimensional ultrasonic scanning for determining prevailing placenta arrangement side, taking capillary blood sample and counting lymphocyte number. Left-sided placenta arrangement being the case, and lymphocyte content in blood formula being equal to or below 20%, unfavorable labor outcome is predicted.
EFFECT: high accuracy in detecting pregnant women with unfavorable prognosis and placing them among risk group.
SUBSTANCE: method involves carrying out location measurements using transducer of 7.5 L in B mode, color dopplerometry mapping mode and in D mode. When obtaining an image characterized by anechogenic elongated formation having echogenic banding in B mode, high speed flow image with blood circulation directed towards the arteriovenous malformation in color dopplerometry mapping mode and bypass pattern image with high systolic and diastolic blood circulation speed and low pulsation index and resistance index values in D mode, adductor blood vessel in cerebral arteriovenous malformation is verified when having all the images located at the same place.
EFFECT: high reliability and accuracy of diagnosis.
FIELD: medicine, functional diagnostics, cardiology.
SUBSTANCE: on isolating the trunk of pulmonary artery one should measure circulation in its wall with the help of a laser-doppler flowmeter to detect average value of microcirculation, root-mean-square and interval of deviation against average value. Then one should detect average value of microcirculation and the value for circulation decrease after replacing the trunk of pulmonary artery into aortic position. If average value of microcirculation in the wall of pulmonary artery in position of aortic valve has been decreased by the value either equal or below 1.282xσ, one should predict favorable result of operation, if the decrease occurred by more than 1.282xσ, one should predict unfavorable result of operation. The method broadens the number of diagnostic means applied in the field of cardiosurgery.
EFFECT: higher efficiency and accuracy of prediction.
SUBSTANCE: method involves determining hemodynamic characteristics of blood circulation in vascular anastomosis area in standard zones distal and proximal with respect to the vascular anastomosis by means of ultrasonic dopplerography during the first 6 months, after vascular plastic operation being applied. Dynamic changes in the characteristics are interpreted in terms of full-valued vascular anastomosis condition.
EFFECT: high accuracy of diagnosis; high accuracy of ultrasonic blood circulation condition criteria.
11 dwg, 2 tbl
SUBSTANCE: method involves carrying out cardiotocographic examination taking into account day rhythmostasis and following data analysis. Diagnostically significant cardiotocographic characteristics like basal rhythm, accelerations, acceleration durations, motor fetus activity and integral fetus state characteristic are determined. Non-conjugated estriol/progesterone coefficient is calculated with day rhythmostasis taken into account. Maternal and fetal blood circulation hemodynamic values synchronization coefficient is determined. Diagnostically significant characteristics values typical for fetus hypoxia are determined. When carrying out cardiotocographic examination, basal rhythm (strokes/min) is equal to 156±2.9 at 12 o'clock and 159±3.7 at 20 o'clock; accelerations (strokes/min) 3.0±0.2 at 12 o'clock and 2.2±0.3 at 20 o'clock; acceleration durations (s) 14.2±0.7 at 12 o'clock and 13.6±1.2 at 20 o'clock; motor fetus activity (during 10 min) 2.0±0.4 at 12 o'clock and 1.7±0.3 at 20 o'clock; integral fetus state characteristic 1.25±0.15 at 12 o'clock and 1.37±0.22 at 20 o'clock. When determining noncojugated estriol/progesterone coefficient: 0.57±0.05 at 8 o'clock and 0.67±0.06 at 20 o'clock. When determining maternal and fetal blood circulation hemodynamic values synchronization coefficient: 2.35±0.19 before 37 pregnancy weeks date and 2.78±0.18 after 37 pregnancy weeks date. The values corresponding to the above referenced ones, functional fetus state change and chronic fetal hypoxia are to be diagnosed.
EFFECT: high accuracy of diagnosis.
FIELD: medicine, oncology.
SUBSTANCE: before the onset and 10-14 d after the end of chemotherapy course it is necessary to carry out chromatic Doppler mapping to evaluate maximal tumor rate of circulation, and at its decreased value being 25% lower against initial data one should establish process stabilization, and at its increase being 25% higher against the initial data - process progressing should be stated upon. The innovation enables to objectively evaluate efficiency of chemotherapy at applying safe, simple ultrasound trial for the purpose to specify subsequent therapeutic tactics.
EFFECT: higher efficiency and accuracy of detection.
8 dwg, 3 ex
SUBSTANCE: one performs ultrasonic echo-dopplerometric investigation of regional blood flow in prostate before and after treatment to determine quantitative parameters. When pulsation index is reduced from 1.39±0.12 before treatment to 1.10±0.09 after treatment and venous blood flow velocity increases, respectively, from 3,91±0.36 to 5,22±0.47, treatment is regarded effective and completed.
EFFECT: increased accuracy of estimation.
SUBSTANCE: method involves determining microcirculation indices in rest state by applying Doppler laser flowmetry method and capillary blood circulation reserve indices in occlusion sample under cuff pressure being 30 mm of mercury column as high as the systolic patient blood pressure during 3 min. Cardiorespiratory disorders development is predicted in postoperative period, The microcirculation indices being greater than 6.0 perfusion units in combination with capillary blood circulation reserve indices being greater than 300% or microcirculation indices being below than 4.5 perfusion units in combination with capillary blood circulation reserve indices being greater than 200%.
EFFECT: high accuracy of prognosis.
SUBSTANCE: method involves carrying out visual and rectal examination. Peripheral blood circulation speed is measured in rectovaginal partition blood vessels. Rectovaginal partition folds are detected and increase in its thickness. Levators separation exceeding 20 mm is determined. Fibrous degeneration of rectovaginal partition is detected. Reduced blood circulation speed in levators is detected. Anterior rectocele is diagnosed. Values are measured by introducing ultrasonic transducer into the rectum. One of versions assumes introduction of hygienic intravaginal tampon into the vagina.
EFFECT: high reliability of diagnosis.
2 cl, 8 dwg
SUBSTANCE: method involves carrying out ultrasonic scanning examination of subclavian artery over its whole extent in physiological arm position with arterial blood pressure being measured in the middle one third of the arm. Next, when applying compression tests, blood circulation parameters variations are recorded in distal segment of the subclavian artery with arterial blood pressure being concurrently measured. Three degrees of superior thorax aperture syndrome severity are diagnosed depending on reduction of linear blood circulation velocity and arterial blood pressure compared to their initial values. Mild one takes place when linear blood circulation velocity reduction reaches 40% and arterial blood pressure 20% of initial level, moderate one when linear blood circulation velocity reduction reaches 70% and arterial blood pressure 50% and heavy one when linear blood circulation velocity reduction is greater than 70% of initial level and arterial blood pressure is greater than 50% to the extent of no blood circulation manifestation being observed in the subclavian artery.
EFFECT: high accuracy of diagnosis.
FIELD: medicine, urology.
SUBSTANCE: one should conduct subcutaneous prevocational tuberculin test and, additionally, both before the test and 48 h later it is necessary to perform the mapping of prostatic vessels and at decreased values of hemodynamics one should diagnose tuberculosis. The information obtained should be documented due to printing dopplerograms.
EFFECT: more reliable and objective information.
1 ex, 1 tbl
FIELD: medicine; medical engineering.
SUBSTANCE: method involves applying ultrasonic Doppler echolocation techniques for scanning blood circulation at selected area of cardiovascular system, determining blood circulation velocity vector projections and calculating blood circulation speed. Echolocation is carried out by using at least three non-complanar probing ultrasonic rays set at angles relative to selected area of cardiovascular system in the range of 0-±80°. Selected blood circulation area orientation angles are measured relative to scanning ultrasonic rays and Doppler frequency shifts in each measuring channel are determined. Blood circulation speed is calculated as where ω0i is the radiation frequency of ultrasonic oscillation in ray I, Δωi is the Doppler frequency shifts in measuring channel i, V is the ultrasonic wave propagation speed in the medium, ϑk is the blood circulation speed in selected area, ϑki is the blood circulation velocity projection to scanning ray i, a,b,c,h,k,n11,n12,n13 are the coefficients depending on ultrasonic rays orientation. The device has measuring unit having ultrasonic transducers and electronic unit having switch, high frequency oscillator, calculating unit, indication and control unit. The measuring unit is manufactured as bracelet which segments are connected to each other by means of adjustable hinges and has gages for measuring lateral segment orientation angles relative to the central segment and gages for measuring ultrasonic transducer orientation angles relative to the i-th segment where i = 1,2,3, connected to calculating unit, switch, indication and control unit connected to high frequency oscillator, ultrasonic transducers of the measuring unit are connected via the switch to the high frequency oscillator.
EFFECT: high accuracy of measurements; wide range of functional applications.
2 cl, 2 dwg
SUBSTANCE: method involves measuring forced exhalation volume per 1 s. Systolic pressure in pulmonary artery and ratio of maximum blood circulation speeds through tricuspid valve into diastole. Prediction is carried out on basis of value calculated from mathematical formula including measured and calculated parameters.
EFFECT: enhanced effectiveness of prediction.
SUBSTANCE: method involves measuring forced exhalation volume per 1 s (FEV1) in l, full right ventricle evacuation time (RVE) in ms and angiotensin II value (AII) in ng/l. Discriminant relationship is built as D=0.504·RVE+3.038·FEV1 - 2.0·AII. D being less than 83.88, pulmonary hypertension occurrence is predicted within 1 year. D being equal to or greater than 83.88, no pulmonary hypertension is predicted to occur.
EFFECT: enhanced accuracy of prediction.
FIELD: medicine, nephrology.
SUBSTANCE: one should detect circulation rate characteristics and vessel's diameter due to dopplerography, moreover, on should measure vessel's diameter directly in area of anastomosis, as for circulation rate characteristics they should be determined in constant-wave Doppler mode in area of circulation's maximal rate. Moreover, one should measure anastomosis' cross-sectional area and heart rate, moreover, one should calculate circulatory volume through anastomosis by the following formula: V(ml/min) = A VTI HR, where A - anastomosis' cross-sectional area (sq. cm), VTI - integral of circulatory linear rate through anastomosis (cm), HR - heart rate.
EFFECT: higher accuracy of detection.
4 ex, 1 tbl
SUBSTANCE: method involves determining linear blood circulation speed above and below diaphragm using dopplerography approach. State severity class is determined as healthy, recovering and heavy from measured linear velocities ratio. Applied therapy effectiveness is determined on the measured linear velocities ratio exiting beyond the scope of severity class range, when analyzing patient state dynamics.
EFFECT: high accuracy in estimating patient health state.
FIELD: medicine, hepatology.
SUBSTANCE: one should detect splenic length in mm (X1) and circulation in portal vein, moreover, additionally, on should detect volumetric circulation in splenic vein in cu. cm/min. (X2), the index for the ratio of volumetric circulation in splenic vein to the area of longitudinal splenic section (X3), circulatory direction in left-hand gastric vein (X4) by establishing its direction towards the liver to be 1, from the liver to be 2, diameter of splenic artery in cm (X5) and transhepatic portal volumetric circulation in cu. cm/min. (X6), then one should calculate discriminant function Z = 15.9850 - 0.0187X1 + 0.2006X3 - 1.9025X4 - 19.0493X5 - 0.0025X6, where Z - the criterion for predicting "healthy-sick" state; then it is necessary to detect the group with hepatic diseases by the value of Z ≤ 1.621 to calculate for them discriminant function Y = 9.7396 - 0.0279X1 - 0.0018X2 + 0.1873X3 - 4.9174X4, where Y - the criterion to predict "patients with chronic hepatitis - patients with cirrhosis" state and at Y > 1.239 one should diagnose chronic hepatitis, at Y ≤ 1.239 - cirrhosis.
EFFECT: higher efficiency of diagnostics.
FIELD: medicine, cardiology, endocrinology, gynecology.
SUBSTANCE: one should detect informational-valuable signs of patient's state, such as either the presence or absence of hypertonic disease and uterine extirpation together with adnexa, the value of body weight index, predominance of disorders according to modified menopausal index (MMI)such as autonomic, metabolic-endocrine or psycho-emotional ones, the type of metabolic structures of blood serum, moreover, it is necessary to echocardiographically detect stroke volume, cardiac index and systemic vascular resistance (SVR), at ultrasound testing one should detect maximal linear rate of circulation (LRC max) by medial cerebral artery and thyroid alterations, rheovasographically one should detect specific circulation (SC) of shins, at testing laser doppler flowmetry one should detect microcirculation index, biochemically it is necessary to detect the value of beta-adrenoreactivity, cholesterol level and that of B-lipoproteides, crystallographically - the presence of serotonin and dopamine crystals, due to immunoenzymatic assay on should detect the values by Table 1 and then after obtaining the values of diagnostic coefficients of every parameter it is necessary to summarize them and obtain diagnostic index (DI), at its value being below 10 one should state no alteration, at its value 10-10 - undetermined state, at its value being 21-30 - the 2nd severity degree of disorders, and at DI value being above 31 one should state the 3d severity degree of disorders available.
EFFECT: higher accuracy of evaluation.
5 ex, 2 tbl
FIELD: medicine, obstetrics, gynecology.
SUBSTANCE: one should study circulation in one of fetal renal arteries during the second half of third trimester of pregnancy. At increased resistance index from 0.81 and higher and, correspondingly, systolodiastolic ratio - from 5.1 and higher - one should fix the presence of fetal hypoxia and the necessity for urgent correction of this state. The suggested method increases the number diagnostic preparations and enables to increase the significance of predicting the state of neonatals.
EFFECT: higher accuracy of evaluation and prediction.
5 dwg, 5 ex, 1 tbl