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뇌혈류초음파검사에서의 주의사항 및 제안

Precautions and Suggestions for Transcranial Doppler Ultrasonography

  • 투고 : 2023.06.22
  • 심사 : 2023.07.30
  • 발행 : 2023.09.30

초록

뇌혈류초음파(TCD) 검사는 일반적으로 2 MHz의 낮은 주파수를 이용해서 두개강 내의 혈류속도 및 파형을 측정하는 검사이다. 많은 병원에서 병리사들이 검사를 시행하고 있고 학교, 뿐만 아니라 학회차원에서 교육들도 이루어지고 있다. 하지만 TCD검사는 검사자의 스킬이 무엇보다 중요한 검사 중에 하나다. 처음으로 검사를 접하는 검사자들은 혈관이 잘 찾아지지 않아 고민이 생기고, 어느 정도 경험한 검사자들은 혈관이 너무 많이 찾아져서 고민이 된다고 한다. 직접 혈관을 보고 측정하는 검사가 아니기 때문에 많은 제한과 어려움이 있을 수밖에 없다. 그래서 TCD 검사자들을 위해서 검사를 시행할 때 주의사항과 노하우를 소개함으로써 도움을 드리고자 한다.

Transcranial doppler ultrasonography (TCD) applies a low frequency of 2 MHz to measure the blood flow velocity and waveform within the skull. Medical technologists at several hospitals are conducting these examinations, and education is being imparted in many schools and academic societies. However, the skill of the tester is of utmost importance when performing TCD. Technicians who are conducting the procedure for the first time have trouble locating the blood vessels, and some experienced personnel are worried because too many blood vessels are present. Since this procedure does not directly look at and measure blood vessels, there are several limitations and difficulties. Therefore, this study aims to provide some help by introducing precautions and suggestions for TCD technicians conducting the test.

키워드

참고문헌

  1. Aaslid R. Transcranial Doppler sonography. Springer-Verlag: 1986.
  2. Kim JS, Lee SW, Eun MY, Seo WK. Power motion-mode Doppler signature: a useful tool for assessing m iddle cerebral artery stenosis. J Clin Ultrasound. 2014;42:348-354. https://doi.org/10.1002/jcu.22134
  3. Sloan MA, Alexandrov AV, Tegeler CH, Spencer MP, Caplan LR, Feldmann E, et al. Assessment: transcranial Doppler ultrasonography: report of the therapeutics and technology assessment subcommittee of the american academy of neurology. Neurology. 2004;62:1468-1481. https://doi.org/10.1212/wnl.62.9.1468
  4. Alexandrov AV, Sloan MA, Wong LK, Douville C, Razumovsky AY, Koroshetz WJ, et al. Practice standards for transcranial Doppler ultrasound: part I--test performance. J Neuroimaging. 2007;17:11-18. https://doi.org/10.1111/j.1552-6569.2006.00088.x
  5. Serrador JM, Picot PA, Rutt BK, Shoemaker JK, Bondar RL. MRI measures of middle cerebral artery diameter in conscious humans during simulated orthostasis. Stroke. 2000;31:1672-1678. https://doi.org/10.1161/01.str.31.7.1672
  6. Babikian VL, Wechsler LR. Transcranial Doppler ultrasonography. 2nd ed. Butterworth-Heinemann: 1999.
  7. Bathala L, Mehndiratta MM, Sharma VK. Transcranial Doppler: technique and common findings (Part 1). Ann Indian Acad Neurol. 2013;16:174-179. https://doi.org/10.4103/0972-2327.112460
  8. Lizzi FL, Coleman DJ, Driller J, Franzen LA, Jakobiec FA. Experimental, ultrasonically induced lesions in the retina, choroid, and sclera. Invest Ophthalmol Vis Sci. 1978;17:350-360.
  9. Gray CS, Karimova G, Hildreth AJ, Crabtree L, Allen D, O'connell JE. Recovery of visual and functional disability following cataract surgery in older people: Sunderland cataract study. J Cataract Refract Surg. 2006;32:60-66. https://doi.org/10.1016/j.jcrs.2005.07.040
  10. Zheng XN, Zhu XC, Xu QF, Huang YN, Liu Y. TCD study of hemodynamic changes in PCA response to photic stimulation. J hejiang Univ Sci. 2003;4:228-231. https://doi.org/10.1631/jzus.2003.0228
  11. Lee CH, Yoo D, Kwon HM, Lee YS. A comparison of transcranial Doppler and magnetic resonance imaging for long term changes in middle cerebral artery stenosis. Clin Neurol Neurosurg. 2019;182:37-42. https://doi.org/10.1016/j.clineuro.2019.04.021
  12. Aoki J, Kimura K, Iguchi Y, Shibazaki K, Kobayashi K, Sakai K, et al. A combined TCD and MRA screening for significant siphon portion of internal carotid artery (S-ICA) stenosis. J Neuroimaging. 2012;22:172-176. https://doi.org/10.1111/j.1552-6569.2010.00567.x
  13. Yonan KA, Greene ER, Sharrar JM, Caprihan A, Qualls C, Roldan CA. Middle cerebral artery blood flows by combining TCD velocities and MRA diameters: in vitro and in vivo validations. Ultrasound Med Biol. 2014;40:2692-2699. https://doi.org/10.1016/j.ultrasmedbio.2014.05.022
  14. Babikian VL, Feldmann E, Wechsler LR, Newell DW, Gomez CR, Bogdahn U, et al. Transcranial Doppler ultrasonography: year 2000 update. J Neuroimaging. 2000;10:101-115. https://doi.org/10.1111/jon2000102101
  15. Purkayastha S, Sorond F. Transcranial Doppler ultrasound: technique and application. Semin Neurol. 2012;32:411-420. https://doi.org/10.1055/s-0032-1331812
  16. Alexandrov AV, Neumyer MM. Intracranial cerebrovascular ultrasound examination techniques. In: Alexandrov AV, editor. Cerebrovascular ultrasound in stroke prevention and treatment. Blackwell Publishing: 2004. p. 17-32.
  17. Hennerici M, Rautenberg W, Sitzer G, Schwartz A. Transcranial Doppler ultrasound for the assessment of intracranial arterial flow velocity--Part 1. Examination technique and normal values. Surg Neurol. 1987;27:439-448. https://doi.org/10.1016/0090-3019(87)90251-5
  18. Poulin MJ, Liang PJ, Robbins PA. Dynamics of the cerebral blood flow response to step changes in end-tidal PCO2 and PO2 in humans. J Appl Physiol. 1996;81:1084-1095. https://doi.org/10.1152/jappl.1996.81.3.1084
  19. Min JH, Lee YS. Transcranial Doppler ultrasonographic evaluation of vertebral artery hypoplasia and aplasia. J Neurol Sci. 2007;260:183-187. https://doi.org/10.1016/j.jns.2007.05.001
  20. Lee JY, Yu SW, Lee SI, Jung KH, Seo WK, Park JM, et al. Transcranial Doppler ultrasound: practice standards part I. Test performance and interpretation. J Neurosonol. 2016;8:1-13.