한국인에서 경두개 초음파검사의 혈류감지와 관련된 인자들

Abstract

Background : Although transcranial doppler sonography (TCD) is a useful technique evaluating cerebral blood flow velocity, temporal acoustic window failure (TWF) limits its wide application in stroke patients. However, factors related to TWF remain unknown. The purpose of this study was to investigate the factors effecting TWF. Methods : We performed TCD in 104 consecutive patients (62 males and 42 females, aged 38 - 84 years) with ischemic stroke. We assessed the bone mineral density (g/cm2) of the L2, femur and the skull using bone mineral densitometry and measured the thickness of temporal bone shown in the CT scan with the use of PACS system. Results : Blood flow signals were recorded in 136(65.4%) of the 208 middle cerebral arteries. TWF was more common in women than men - 59.5%(50/84) vs. 17.7%(22/124) (p<0.001). Patients with TWF was significantly older than those without - 70.2¡¾8.4 years vs. 63.1¡¾7.2 years in women(p<0.005) and 67.4¡¾10.7 years vs. 60.9 ¡¾8.5years in men(p<0.001). TWF was not related with bone mineral density after adjusting the age and sex. However, the thickness of temporal bone was significantly greater in patients with TWF (3.3¡¾0.7 mm) than those without (2.3¡¾0.4 mm) (p<0.001). Besides, temporal bone was thicker in women than in men - 3.0¡¾0.8 mm vs. 2.4¡¾0.6 mm (p<0.001). Inhomogeneity in temporal bone was more common in patients with TWF than those without - 89.1% (41/46) vs. 15.4%(4/26) in women and 68.2%(15/22) vs. 18.6%(19/102) in men (p<0.001, each). Conclusions : TWF in Korean patients is related with advanced age, female sex and temporal bone thickness and inhomogeneity, but not with the mineral density of the temporal bone.