Method for monitoring blood circulation in cerebral blood vessels
SUBSTANCE: method involves measuring intracranial blood circulation velocity parameters by means of dopplerography approach using bilaterally arranged transducers. Intracranial venous collector and intracranial arterial blood vessel are concurrently measured on the pathological side. The arterial blood vessel is located with transducer set on the opposite side relative to the pathological focus and the venous one on the side of the pathological focus.
EFFECT: high reliability in estimating blood circulation parameters.
The invention relates to medicine, namely to vascular neurosurgery and vascular neurology, and can be used for monitoring blood flow with a comprehensive assessment of alterations of blood flow in the brain during and in the first hours after surgery and to assess the effectiveness of surgical treatment. The main ways to assess intra and postoperative changes of blood vessels in the brain is monitored and, in the first place, ultrasound, transcranial method of locating a blood vessel in the brain.
Closest to the claimed is a method of monitoring blood flow in cerebral vessels (B.v.gaidar, Wearden, D.v.svistov "Transcranial Doppler in neurochirurgie" St. Petersburg Umea, 2000, s.43-44)adopted for the prototype.
With external ultrasonic sensors, rigidly fixed on the head, in the standard Windows locations from disease and healthy by the permanent location of the speed of blood flow parameters in the two middle cerebral arteries, or in the two anterior cerebral arteries, or in the two posterior cerebral arteries in pairs, with each sensor scan the artery with his hand.
The disadvantages of the prototype: it is impossible to adequately assess the significance of hemodynamic changes according to the change of only one arter the material of the vessel on the side of pathology.
The invention is directed to a method of monitoring blood flow in the vessels of the brain, to adequately assess the significance of hemodynamic changes by taking into account indicators of arterial and venous components.
This technical result in the implementation of the method is achieved in that in the known method of monitoring blood flow in the vessels of the brain, including Doppler measurement of the speed parameters of intracranial blood flow through bilateral located ultrasonic sensors, the peculiarity lies in the fact that produce simultaneous measurement of intracranial venous reservoir and intracranial blood vessel on the side of the pathology, while blood vessel scan sensor opposite to the pathology side, and the venous - side pathology.
The method is as follows.
The patient is set on two sides two standard ultrasonic probe 2 MHz, which through standard sonographic window monitor most involved in the pathological process of intracranial arteries and veins. Assessment of blood flow in intracranial Vienna produced by pathology, and the location of the artery on the side of the disease is performed by the sensor, set the Lenna from the opposite side. The proposed method allows the simultaneous assessment of changes in blood flow during and after surgery for arterial and venous component from pathology.
The inventive method is developed and clinically tested in the Polenov research neurosurgical Institute them. Prof. Operated during examination 3 patients with AVM of the brain vessels of different localization.
Examples of extracts from the histories.
Patient K., 33 years old, n and/b 131-2004, with diagnoses AVM posterior cranial fossa, occlusive hydrocephalus. 02.2004 was performed intravascular, superselective embolization of the AVM histogram. In addition to routine preoperative Doppler examination, the patient during the operation was carried out monitoring according to the claimed method. AVM was closed at 80%, followed by 6-hour postoperative monitoring, which allowed us to obtain precise data on venous and arterial components of the AVM in the first hours after the intervention.
The main changes based on monitoring results observed in the arterial component.
C. for 17 years, and a/b No. 318-2004 was diagnosed with arteriovenous malformation of the left frontal lobe, spasms, SAK from 07.2003. Was performed embolization 90% of the AVM with post-surgical monitoring of arterial and venous component in pervachey after the operation.
The use of the claimed method exactly, affordable and non-invasive allowed us to assess the condition of the arterial and venous parts in the dynamics after interventions on the brain vessels.
C. for 22 years, n and/b 784-2004 diagnosed with AVM left frontal and parietal lobes. Made intravascular embolization of histogram. Malformation off from blood flow by 50%. According to the results of postoperative monitoring major changes occurred in arterial and in venous link.
The inventive method allows to adequately assess the significance of hemodynamic changes in various pathologies, given the performance of the arterial and venous components.
Method of monitoring blood flow in the vessels of the brain, including Doppler measurement of the speed parameters of intracranial blood flow through bilateral located ultrasonic sensors, characterized in that produce simultaneous measurement of intracranial venous reservoir and intracranial blood vessel on the side of the pathology, while blood vessel scan sensor opposite to the pathology side, and the venous - side pathology.
SUBSTANCE: method involves recording blood circulation rate in large arteries of brain base in continuous bilateral mode. Spectral density of linear blood circulation rate B-waves is estimated in the range of 0.008-0.033 Hz. Spectral density of B-waves growing above 1000 (cm/s)2/Hz proves cerebral blood flow autoregulation disorders to take place.
EFFECT: high accuracy of diagnosis.
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
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 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