Pulsatility Index Measurement via the Submandibular Internal Carotid Artery: An Alternative to Transcranial Assessment.

IF 4.2 3区医学 Q2 CLINICAL NEUROLOGY

Neurocritical Care Pub Date : 2026-10-01 Epub Date: 2026-04-06 DOI:10.1007/s12028-026-02505-3

Yoshihisa Fujimoto, Kenji Numata, Aya Sakuma, Tsukasa Yoshida, Koichi Hayashi, Shigeki Fujitani

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引用次数: 0

Abstract

Background/objective: Pulsatility index (PI) measurements using transcranial color flow imaging via the temporal bone are one of the clinical substitutes for invasive intracranial pressure (ICP) monitoring. Although the PI measurements obtained through this window are commonly used, they cannot be evaluated in up to 20% of the patients. Given that PI in the internal carotid artery (ICA) can be easily measured through the submandibular window in all cases, this study aimed to investigate whether PI measurements through the submandibular window could be used as a substitute for PI measurements in the middle cerebral artery (MCA).

Methods: This single-center, retrospective, observational study included cases from our intensive care unit between May 2024 and September 2024, in which transcranial ultrasound was performed during treatment of neurological disorders. The PI measurements from the temporal (MCA-PI) and submandibular (ICA-PI) windows were obtained at the same situation; the correlation between ICA-PI and MCA-PI was evaluated across various brain injuries using Pearson's correlation coefficient.

Results: Data from 46 patients, totaling 116 measurements, were analyzed. The patients included 57 (49.1%) male patients aged 67 (interquartile range [IQR], 49-74) years. The primary diagnoses were subarachnoid hemorrhage [n = 52 (44.8%)], intracerebral hemorrhage [n = 21 (18.1%)], cerebral infarction [n = 9 (7.8%)], and traumatic brain injury [n = 8 (6.9%)]. The median MCA-PI was 1.11 [IQR: 0.87-1.36] and the median ICA-PI was 1.09 [IQR: 0.86-1.37]. A significant correlation was observed between the ICA-PI and MCA-PI, with a correlation coefficient of 0.894 (MCA-PI = 0.946 × ICA-PI + 0.057).

Conclusions: Despite the inclusion of various neurocritical disorders, the ICA-PI through the submandibular window was strongly correlated with the conventional PI (i.e., MCA-PI through the temporal window). In neurocritical care, the ICA-PI may be used in combination with other ICP surrogate markers for integrated assessment when the view through the temporal window is unavailable.

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通过下颌下颈内动脉测量脉搏指数：一种替代经颅评估的方法。

背景/目的：利用经颅颞骨彩色血流显像测量脉搏指数（PI）是临床替代侵入性颅内压（ICP）监测的方法之一。虽然通过这个窗口获得的PI测量是常用的，但它们不能在高达20%的患者中进行评估。鉴于所有病例均可通过下颌下窗轻松测量颈内动脉（ICA） PI，本研究旨在探讨下颌下窗PI测量是否可替代大脑中动脉（MCA） PI测量。方法：本研究为单中心、回顾性、观察性研究，纳入我院重症监护室于2024年5月至2024年9月在治疗神经系统疾病期间行经颅超声的病例。在相同的情况下获得颞窗（MCA-PI）和下颌下窗（ICA-PI）的PI测量值；使用Pearson相关系数评估不同脑损伤ICA-PI和MCA-PI之间的相关性。结果：对46例患者的116项测量数据进行分析。男性患者57例（49.1%），年龄67岁（四分位间距[IQR]， 49 ~ 74）。主要诊断为蛛网膜下腔出血[n = 52(44.8%)]、脑出血[n = 21(18.1%)]、脑梗死[n = 9(7.8%)]、创伤性脑损伤[n = 8(6.9%)]。中位MCA-PI为1.11 [IQR: 0.87-1.36]，中位ICA-PI为1.09 [IQR: 0.86-1.37]。ICA-PI与MCA-PI呈显著相关，相关系数为0.894 （MCA-PI = 0.946 × ICA-PI + 0.057）。结论：尽管包括各种神经临界障碍，但通过下颌下窗的ICA-PI与传统的PI（即通过颞窗的MCA-PI）密切相关。在神经危重症监护中，当无法通过时间窗观察时，ICA-PI可与其他ICP替代标记物联合使用进行综合评估。

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

Neurocritical Care 医学-临床神经学

CiteScore

7.40

自引率

8.60%

发文量

221

审稿时长

4-8 weeks

期刊介绍： Neurocritical Care is a peer reviewed scientific publication whose major goal is to disseminate new knowledge on all aspects of acute neurological care. It is directed towards neurosurgeons, neuro-intensivists, neurologists, anesthesiologists, emergency physicians, and critical care nurses treating patients with urgent neurologic disorders. These are conditions that may potentially evolve rapidly and could need immediate medical or surgical intervention. Neurocritical Care provides a comprehensive overview of current developments in intensive care neurology, neurosurgery and neuroanesthesia and includes information about new therapeutic avenues and technological innovations. Neurocritical Care is the official journal of the Neurocritical Care Society.