• 대한방사선기술학회지:방사선기술과학
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• 제44권1호
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• pp.15-23
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• 2021

In this case analysis, a patient was diagnosed with subarachnoid hemorrhage (SAH) in a 49-year-old female and showed persistent vasospasm after coil emboilzation in an aneurysm. The patient suffered from persistent vasospasm and performed angioplasty a total of 6 times. Transcranial color coded doppler (TCCD) was performed 12 times to monitor vasospasm. As a result, repetitive cerebral blood flow tests were low cost and safely performed without exposure to invasive radiation through the TCCD, and the repeatability and reproducibility of the test were confirmed with the capabilities of a trained professional radiological technologist.

• 대한임상검사과학회지
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• 제56권3호
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• pp.277-287
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• 2024

경두개 도플러(transcranial doppler, TCD) 초음파는 뇌혈류를 평가하는 데 중요한 비침습적 도구로, 뇌혈관 질환의 진단과 모니터링에 널리 사용되고 있다. 본 논문은 TCD의 중요성을 재확인하고, 검사 방법 및 주의 사항을 정리하여 실무자에게 가이드를 제공하고자 한다. TCD는 혈류 속도 변화를 평가하여 뇌혈관 협착, 폐색, 혈류 역학적 변화를 평가한다. 그러나 혈류 속도만으로는 혈류량 증가와 혈관 직경 감소를 구분하기 어렵다. 따라서 임상 소견과 혈류 역학적 변화를 통합적으로 고려한 종합적 접근이 필요하다. TCD 결과의 신뢰성은 검사자의 기술에 크게 의존하므로 표준화된 절차와 지속적인 교육 및 훈련이 필요하다. TCD 분석의 자동화와 인공지능(AI) 기술의 발전은 정확성과 신뢰성을 향상시킬 수 있는 잠재력을 가지고 있다. 향후 연구는 이러한 새로운 기술들을 검증하고 임상에 적용하는 데 중점을 두어야 한다. 본 논문은 TCD의 중요성, 검사 방법, 주의사항을 검토하며, 실무자에게 유용한 가이드를 제공하고자 한다. TCD의 지속적인 발전과 임상 적용 확대가 뇌혈관 질환의 진단 및 치료에 기여하기를 기대한다.

• The Journal of Korean Physical Therapy
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• 제15권1호
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• pp.196-209
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• 2003

The aim of study was compared with the possible role of cranial artery in headache pathogenesis each 2 group (group I : ultrasound therapy alone, group II : myofascial release therapy alone)- divided each 5 tension- type headache patients. Each group were applied ultrasound therapy for 5 minuets and myofascial release therapy for 15 minuets in occipital portion. The study carried out to determine the effects of ultrasound and myofascial release on the cranial arteries velocity from November 11, 2001 to March 29, 2002 the objects were 10 patients who having the tension-type headache at H-hospital. Transcranial doppler ultrasonograpy(TCD) is new non-invasive applicable method to evaluate flow velocities of intrans cranial and extracranial cerebral arteries. TCD was peformed with standard method to measure the Mean Flow Velocity(MFV) of the middle and posterior cerebral arteries, the vertebral arteries.

• 대한한방내과학회지
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• 제20권1호
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• pp.222-231
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• 1999

Uwhangchungsimwon(UC) has been used in the treatment of a wide variety of conditions including stroke, hypertension, arteriosclerosis, autonomic imbalance, mental instablity, etc in Korean traditional hospitals, In particular it is often initialy chosen for emergency care of acute stroke. The aim of this study was to evaluate the effect of UC on cerebral hemodynamics. Using transcranial Doppler ultrasound, we studied changes of mean flow velocity and pulsatility index(PI) of middle cerebral arteries (MCAs) from 11 health young volunteers who were administrated with 1 pill UC and 11 health controls who were not. We obtained hypercapnia with breath-holding and evaluated cerebrovascular reactivity with breath-holding index(BHI). Systolic blood pressure, diastolic blood pressure, and heart rate were measured using ambulatory blood pressure monitoring(ABPM). In UC administration group, the evaluation was performed during basal condition. and repeated at 20, 40, and 60 min after administration. In controls, the evaluation was performed at corresponding time intervals. Mean flow velocity in middle cerebral artery, systolic blood pressure, diastolic blood pressure, and heart rate did not change during the observation period and were not different between these two groups. However, administration of UC was associated with decreases in PI by $3.6{\sim}12.4%$ in BHI by $17.9{\sim}24.8%$ compared with pre-administration period. Decreases in PI and BHI with UC were significantly different compared with control group (p<0.05). These results indicate that UC decreases PI and BHI in cerebral artery, which is due to a dilation of cerebral resistance vessels.

• 대한의생명과학회지
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• 제25권4호
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• pp.381-389
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• 2019

The physiological function test is the only patient contact area in the field of clinical laboratory. We need to recruit and encourage the experts due to requiring the expertise and long time for examination. However, there is currently no rule for estimating optimal workforce in the field of physiological function tests. The purpose of this study is to establish the basis of the studies for mid- to long-long term job creation in the field of ultrasound by evaluating the number of appropriate tests and appropriate workforce. We calculated the quantitative and qualitative workload for the number of appropriate tests and appropriate workforce using online questionnaire. All statistical analyses were performed using SPSS version 18.0 (SPSS Inc., Chicago, IL, USA). A total of 216 respondents were 48 (22.2%) male and 168 (77.8%) female. A total of 157 laboratories were 62 (39.5%) for echocardiography, 91 (58.0%) for the transcranial Doppler (TCD) and 4 (5.7%) for the carotid ultrasound. The mean number of appropriate tests was 10 ± 2 in the echocardiography, 9 ± 2 in TCD and 11 ± 2 in the carotid ultrasound. In addition, the number of laboratories required to recruit employees for appropriate workforce was 19 in echocardiography, 18 in TCD, and 0 in carotid ultrasound. The number of hospital required to recruit workforce were 7 primary hospitals, 22 secondary hospitals, 7 third hospitals. This study can be used as an important data as the first study at present time when the data on the workforce status and work environment of the ultrasonic laboratories is insufficient. Based on the quantitative and qualitative workloads, the number of appropriate tests and appropriate workforce can support mid- to long-long term job creation in the field of ultrasound.

• 대한임상검사과학회지
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• 제55권3호
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• pp.219-226
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• 2023

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.

• 대한한방내과학회지
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• 제25권3호
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• pp.418-426
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• 2004

Objectives : This study was designed to research whether transcranial doppler ultrasound(TCD) can yield a suitable diagnosis or prognosis for dizziness. Methods : To evaluate the blood flow, we measured the mean velocity(Vm), peak systolic velocity(Vs) and pulsatility index(PI) of the middle cerebral artery(MCA), vertebral artery(VA) and basilar artery(BA) in 54 dizziness patients and 44 normal subjects. To investigate the difference between dizziness patients and normal subjects, we selected 54 dizziness patients diagnosed normal by Brain MRI, and 44 normal subjects who did not have any symptoms of hyperlipemia, hypertension, diabetes melitus, heart disease, or smoking, diagnosed normal by Brain MRI. 30-69 year olds were divided into 30-49 year olds, 50-59 year olds and 60-69 year olds. Results : In normal subjects, there was a significantly higher Vm, Vs in the MCA and BA, and Vs in the VA of female subjects, and there was a significant difference in PI in the MCA and BA increasing with age. In comparison with normal subjects, dizziness patients had a significantly lower Vm in the BA. Male dizziness patients had significantly lower PI in the MCA. 30-49 year olds had significantly lower Vm in the BA. Conclusions : The significant difference in blood flow velocities in the BA between dizziness patients and normal subjects suggests that dizziness is related to blocking of blood flow in the BA and that diagnosis and prognosis can be made through TCD. More detailed study of dizziness patients will be needed.

• 대한한의진단학회지
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• 제14권2호
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• pp.85-100
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• 2010

Objectives: The purpose of this study was to evaluate diagnostic value of Transcranial Doppler Ultrasound about risk factor of stroke by comparing blood flow between patients with metabolic syndrome(MS group) and Normal group. Methods: 62 metabolic syndrome patients and 106 healthy adults were selected who had no cerebrovascular diseases, cardiovascular diseases and other systemic diseases. We measured the mean velocity(Vm), peak systolic velocity(Vs) and pulsatility index(PI) of MCA, ACA, PCA, VA, ICA in two groups using TCD. All subjects were divided by gender and age. Results: In comparing Ms group with normal group, Vm in the MCA, ACA, PCA, ICA and Vs in the MCA, ICA were lower in MS group. In all vessels, PI of MS group were higher than that of Normal group. In all vessels, Vm and Vs revealed negative correlation with age and PI revealed positive correlation with age. In 20-39 year olds, there was decrease in the Vs and Vm and increase of PI of MS group in comparison with normal group. There was significant difference in the Vm of PCA, ICA, Vs of MCA, PCA, ICA and PI of MCA, ACA. In 40-59 year olds, Vm in the MCA, ACA, ICA and Vs in the MCA, ACA were lower in MS group. PI in the MCA, ACA, PCA, ICA were higher in MS group. In 60-79 year olds, Vm of MCA, PCA, ICA was decreased in MS group than Normal group with no statistical signification. Vs in the MCA was lower and PI in the PCA was higher in MS group. In male, Vm of PCA and Vs of MCA were lower and PI of MCA, ACA, PCA, ICA were higher in MS group. In female, Vm of MCA, PCA, ICA and Vs of MCA, ICA were lower and PI of ACA, PCA, VA, ICA were higher in MS group. Conclusions: The significant difference in Vm, Vs, PI between MS group and normal group suggests hemodynamic disorder. Screening and prognosing high risk group can be done through TCD and this can be used to prevent stroke. More detailed study will be needed.

• The Journal of Korean Physical Therapy
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• 제22권5호
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• pp.49-56
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• 2010

Purpose: The aim of this study was to evaluate a possible role for cranial artery velocity in cervicogenic headache. Methods: We studied 13 patients with cervicogenic headaches (M=9, F=4, age=$24.50{\pm}3.50\;y$) these were compared to 20 normal subjects (M=10, F=10, age=$23.30{\pm}2.90\;y$). Cervicogenic headache patients were divided into two groups (a myofascial relaxation group, a placebo group). Pain levels were measured using a visual analog scale (VAS). Transcranial Doppler (TCD) ultrasound recordings were used to measure blood flow velocity in the cranial artery. Results: Cervicogenic headache patients exhibited a significantly lower blood flow velocity in the middle cerebral artery. The patients who received an intervention had a significantly higher blood flow velocity in the left middle cerebral artery, right vertebral artery and basilar artery. Compared to the placebo group, the myofascial relaxation group exhibited a significantly decreased level of pain. Conclusion: Cervicogenic headache is pain referred to the head from a source in the cervical spine. Manual therapy affect to cervical spine and soft tissue as well as the passage of these vessels and nerves to recover because it is thought to be able to help.

• 대한한의학회지
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• 제26권1호
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• pp.115-122
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• 2005

Background and objective: Gastrodiae Rhizoma (GR), the rhizoma of Gastrodia elata BL., is one of the popular drugs to treat headache, dizziness, blackout, numbness of limbs, hemiplegia, facial paralysis, dysphrasia, and infantile convulsions. It has been reported that it provides an antihypertensive effect and lowers cerebrovascular resistance in animal experiments. However, there has been no data about these effects with human subjects. In this study, the author examined the effect of Gastrodiae water extracts on blood pressure and cerebrovascular reactivity in human subjects. Methods: We selected 16 normal volunteers, who were divided into 2 groups: Gastrodiae extract administration group and placebo (creamy powder) group. Using transcranial Doppler ultrasound, we monitored changes of mean flow velocity and breath-holding induced CO2 reactivity of middle cerebral artery in both groups. Mean blood pressure, heart rate and PETCO2 were measured using Compact Anesthesia Monitor. In both groups, all evaluation was performed during basal condition, and repeated at 30, 60, and 90 min after administration. Results: Gastrodiae extract decreased CO2 reactivity after administration, reaching the lowest level at 90 minutes $(-29.1\%\;vs.\;basal\;level)$, which showed significant difference compared with the placebo group (p = 0.004). In the placebo group, the pulse rates tended to decrease over time (at 90 minute, $-5.2\%$ vs. basal level) while in the Gastrodiae group the values showed nearly no change, which showed significant difference between both groups (p = 0.036). However, the changes of mean blood pressure and mean flow velocity did not show significant difference between both groups. Conclusion : This study demonstrated that Gastrodiae extract significantly decreased breath-holding induced CO2 reactivity. This result suggests that the clinical effect of Gastrodiae extract might be caused by increasing cerebral blood flow via dilation of cerebral resistant vessels instead of antihypertensive effect.