METHODS: It was a prospective, hospital-based study performed among patients diagnosed with hydrocephalus. Patients had TCD ultrasonography before V-P shunt. The TCD sonography was repeated within 1 week post-op, and at 1 month post-op. The PI and RI were retrieved after insonating the middle cerebral artery. Ventricular CSF opening pressure was measured. Associations between TCD indices and CSF pressure were determined using the t-test and the Wilcoxon rank /Mann-Whitney tests where the normality test failed. A p-value of < 0.05 was considered significant for associations.
RESULTS: Fifty-two patients were enrolled with a mean age of 9.9 ± 11.5 months. Of these, 41 (78.8%) were aged ≤ 12 months. The mean CSF opening pressure was 21.4 ± 9.0. When raised, ICP was defined as opening pressure > 15 cm of H2O, high PI (≥ 1.19), and high RI (> 0.8) diagnosed it with a sensitivity of 55% and 50%, respectively. The mean pre-operative PI (1.17 ± 0.56) reduced to 0.96 (Z = - 2.032, p = 0.042), while that of RI (0.66 ± 0.17) also decreased to 0.58 (t = 2.906, p = 0.044) after V-P shunt surgery. A strong positive correlation exists between a reduction in PI and RI after V-P shunt (r = 0.743, p = 0.014).
CONCLUSIONS: Both PI and RI significantly decrease following V-P shunt, but a single reading has a poor sensitivity in predicting ICP.
方法:这是一个前瞻性的,在诊断为脑积水的患者中进行了基于医院的研究。患者在V-P分流术前进行TCD超声检查。术后1周内重复进行TCD超声检查,术后1个月。PI和RI在大脑中动脉超声后恢复。测量心室CSF开放压力。使用t检验和Wilcoxon秩/Mann-Whitney检验确定TCD指数和CSF压力之间的关联,其中正态检验失败。<0.05的p值被认为对于关联是显著的。
结果:纳入52例患者,平均年龄9.9±11.5个月。其中,41例(78.8%)年龄≤12个月。平均CSF开放压力为21.4±9.0。当举起时,ICP定义为打开压力>15cmH2O,高PI(≥1.19),和高RI(>0.8)诊断为55%和50%的敏感性,分别。术前平均PI(1.17±0.56)降至0.96(Z=-2.032,p=0.042),V-P分流手术后RI(0.66±0.17)也降至0.58(t=2.906,p=0.044)。V-P分流后PI和RI的降低之间存在强正相关(r=0.743,p=0.014)。
结论:V-P分流后PI和RI均显著降低,但单一读数对预测ICP的敏感性较差。