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首页> 外文期刊>Neurosurgery >Intraoperative measurement of cortical oxygen saturation and blood volume adjacent to cerebral arteriovenous malformations using near-infrared spectroscopy.
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Intraoperative measurement of cortical oxygen saturation and blood volume adjacent to cerebral arteriovenous malformations using near-infrared spectroscopy.

机译：术中使用近红外光谱术测量大脑大脑动静脉畸形附近的皮质血氧饱和度和血容量。

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OBJECTIVE: Both cortical oxygen saturation (SaO(2)) and cortical blood volume (BV) are related to regional cerebral blood flow. Among a series of patients with cerebral arteriovenous malformations, we examined the problem of hyperemia after embolization/resection or resection with the intraoperative application of near-infrared spectroscopy. METHODS: Cortical SaO(2) and BV (intracapillary total hemoglobin concentrations) were measured, with near-infrared spectroscopy, in areas adjacent to the arteriovenous malformation for 20 patients, before and after resection. The absolute values for both parameters and postexcision/preexcision ratios (P-P ratios) were determined. Data were correlated with multiple clinical and preoperative angiographic parameters. RESULTS: Before resection, the mean SaO(2) was 49 +/- 16% and the mean BV was 12.65 +/- 7.41 mg/ml. After resection, SaO(2) increased for 17 of 20 patients and BV increased for 18 of 20 patients. The differences between pre- and postexcision values for both parameters were observed to be statistically significant (P < 0.01). The average P-P ratios were 1.5 +/- 0.4 for SaO(2) and 1.7 +/- 0.4 for BV. Correlation between the P-P ratios for the two parameters was good. The initial BV and the P-P ratios for both SaO(2) and BV were exclusively dependent on the extent of preoperative embolization. Postoperatively, two patients developed intracerebral hemorrhage or severe edema. Both demonstrated high P-P ratios for SaO(2) (2.3 and 2.1) and BV (1.6 and 2.1). CONCLUSION: Intraoperative near-infrared spectroscopy is able to detect the hyperemic status of adjacent cortex after arteriovenous malformation resection. However, staged therapy with embolization and surgery results in less hyperemia after resection. While two patients with hyperemic complications exhibited very large increases in SaO(2) and BV, we cannot refute the normal-perfusion pressure breakthrough theory.
机译：目的：皮层血氧饱和度（SaO（2））和皮层血容量（BV）均与局部脑血流有关。在一系列脑动静脉畸形患者中，我们在术中应用近红外光谱检查了栓塞/切除或切除术后充血的问题。方法：在切除前后，在近动静脉畸形附近，采用近红外光谱法测量了皮质SaO（2）和BV（毛细血管内总血红蛋白浓度）在20例患者的动静脉畸形附近。确定了参数的绝对值以及执行后/执行前的比率（P-P比率）。数据与多种临床和术前血管造影参数相关。结果：切除前，平均SaO（2）为49 +/- 16％，平均BV为12.65 +/- 7.41 mg / ml。切除后，SaO（2）在20例患者中增加了17例，BV在20例患者中增加了18例。观察到两个参数的切除前和切除后值之间的差异具有统计学意义（P <0.01）。 SaO（2）的平均P-P比为1.5 +/- 0.4，BV为1.7 +/- 0.4。两个参数的P-P比率之间的相关性很好。 SaO（2）和BV的初始BV和P-P比率完全取决于术前栓塞的程度。术后两名患者出现脑出血或严重水肿。两者都显示出较高的SaO（2）（2.3和2.1）和BV（1.6和2.1）的P-P比。结论：术中近红外光谱技术能够检测到动静脉畸形切除术后邻近皮质的充血状态。但是，采用栓塞术和手术的分期治疗可减少切除后的充血。尽管两名充血性并发症患者的SaO（2）和BV升高非常大，但我们不能反驳正常灌注压力突破理论。

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