Abstract
Objective. To analyze application of intraoperative ultrasonography and Doppler ultrasonography in patients with acute spinal cord injury. Material and Methods. A complex of intraoperative ultrasonography examinations was performed in 10 patients before and after spinal cord decompression to study pathological structural and hemodynamic lesions. Dura mater, subdural space, liquor, spinal cord, roots of the spinal cord and cauda equina were studied. Color Doppler mapping and ultrasonic duplex scanning were used to identify the arterial and venous vessels of the spinal cord, their anatomic features, linear and volume velocities of the blood flow, resistive and pulsate indices. Doppler ultrasonography of spinal cord vessels included assessment of Doppler spectrum shape, velocity and resistive parameters of the blood flow in the spinal artery. Results. Complex ultrasonic visualization examinations reliably detected spinal cord compressions, cysts, hematoma, contusion foci and subdural hemorrhages. A vascular mode revealed spinal artery occlusion and stenosis, hyper- and hypoperfusion of spinal vessels, reduced blood flow and venous dyscirculation. Conclusion. Thus, methods of complex intraoperative spinal cord ultrasonography are found to be very effective for evaluation of local structural and hemodynamic disturbances caused by spinal cord injury. These ultrasonic techniques are simple in use, highly informative, and comparable with MRI data. These ultrasonic techniques may be recommended for wide application in acute spinal cord injury diagnostics.
Highlights
A complex of intraoperative ultrasonography examinations was performed in 10 patients before and after spinal cord decompression to study pathological structural and hemodynamic lesions
Methods of complex intraoperative spinal cord ultrasonography are found to be very effective for evaluation of local structural and hemodynamic disturbances caused by spinal cord injury
These ultrasonic techniques are simple in use, highly informative, and comparable with MRI data
Summary
Анализ использования интраоперационного ультразвукового исследования и ультразвуковой допплерографии у пациентов с острой позвоночноспинномозговой травмой. В режимах цветового допплеровского картирования и ультразвукового дуплексного сканирования идентифицированы артериальные и венозные сосуды спинного мозга, их анатомические особенности, определены линейная и объемная скорости кровотока, резистивный и пульсационный индексы. При ультразвуковой допплерографии сосудов спинного мозга оценивались форма допплеровского спектра, скоростные и резистивные показатели кровотока по спинальной артерии. Комплексная интраоперационная ультразвуковая диагностика у пациентов с острой позвоночноспинномозговой травмой подтверждает высокую эффективность методики в оценке локальных структурных изменений и гемодинамических нарушений при травматическом повреждении спинного мозга, проста в применении, высокоинформативна, сопоставима с данными МРТ и может быть рекомендована к широкому применению при диагностике осложенных травм позвоночника. Ключевые слова: ультразвуковое исследование, позвоночно-спинномозговая травма, интраоперационная диагностика, операции при позвоночно-спинномозговой травме, ультразвуковая допплерография спинного мозга
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