Ultrasonic Hemodynamics of Middle Meningeal Artery in Chronic Subdural Hematoma

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery Pub Date : 2025-03-14 DOI:10.1016/j.wneu.2025.123793

Xinrun Wang , Zhensheng Liu , Tingyue Qi , Yanhui Shi , Wanwan Hou , Wen Zhang

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引用次数: 0

Abstract

Objective

To explore the feasibility of color Doppler ultrasound (CDUS) in detecting the middle meningeal artery (MMA) and evaluate the clinical application of this method in chronic subdural hematoma (CSDH).

Methods

This study collected clinical data from 100 patients with CSDH who were admitted to our hospital between January 2023 and March 2024. Among these patients, 87 underwent drilling and drainage surgery. Postoperative follow-up categorized patients into a recurrence group and a nonrecurrence group. Additionally, 80 healthy volunteers and 60 patients with acute subdural hematoma were selected as the control group. Using CDUS technology, the MMA was assessed through the infratemporal fossa in the half-mouth position to obtain peak systolic flow velocity (PSV), end diastolic flow velocity, and resistance index (RI). Comparisons were conducted between the study group and the control group, as well as between the recurrence and nonrecurrence groups to evaluate hemodynamic differences. Multivariate logistic regression analysis was employed to identify risk factors for postoperative recurrence in patients with CSDH. Receiver operating characteristic curves were generated to assess the sensitivity and specificity of MMA hemodynamic parameters in predicting postoperative recurrence of CSDH.

Results

The MMA visualization rates for the CSDH group, healthy volunteer group, and acute subdural hematoma group were 84.43% (103/122), 85.00% (136/160), and 83.33% (70/84), respectively. Multivariate logistic regression analysis indicated that bilateral hematoma, increased PSV, and decreased RI were independent risk factors for the recurrence of CSDH following drilling and drainage (P < 0.05). The maximum Youden index was achieved when the PSV predictive value was 30.85 cm/s and the RI predictive value was 0.78.

Conclusions

Utilizing CDUS in a half-open mouth position is a feasible method for evaluating extracranial MMA. Monitoring hemodynamic changes in the MMA of patients with CSDH postsurgery holds significant value in indicating the potential for postoperative recurrence.

查看原文本刊更多论文

慢性硬膜下血肿脑膜中动脉超声血流动力学研究。

目的：探讨彩色多普勒超声检测脑膜中动脉（MMA）的可行性，并评价该方法在慢性硬膜下血肿（CSDH）中的临床应用价值。方法：本研究收集了2023年1月至2024年3月间我院收治的100例CSDH患者的临床资料。其中87例患者行钻孔引流手术。术后随访将患者分为复发组和非复发组。选取80名健康志愿者和60名急性硬膜下血肿（ASDH）患者作为对照组。采用彩色多普勒超声技术，通过半口位颞下窝评估MMA，获得收缩期峰值血流速度（PSV）、舒张末期血流速度（EDV）和阻力指数（RI）。比较研究组与对照组、复发组与非复发组的血流动力学差异。采用多因素logistic回归分析确定CSDH患者术后复发的危险因素。生成ROC曲线，评价MMA血流动力学参数预测CSDH术后复发的敏感性和特异性。结果：CSDH组、健康志愿者组和ASDH组的MMA显示率分别为84.43%（103/122）、85.00%（136/160）和83.33%（70/84）。多因素logistic回归分析显示，双侧血肿、PSV升高、RI降低是钻孔引流术后CSDH复发的独立危险因素(p结论：半张口位彩色多普勒超声是评价颅内外MMA的可行方法。监测CSDH患者术后MMA血流动力学变化对提示术后复发的可能性具有重要价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World neurosurgery CLINICAL NEUROLOGY-SURGERY

CiteScore

3.90

自引率

15.00%

发文量

1765

审稿时长

47 days

期刊介绍： World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS