Zusammenfassung
Ziel: Der Anstieg der Hirngewebetemperatur bei transkraniellen Ultraschallanwendungen (US) ist als mögliche Gefahr für den Patienten beschrieben worden. Hierfür liegen jedoch keine Studien am Menschen, sondern lediglich an verschiedenen Modellen vor. Der Effekt des trankraniellen Duplex-Ultraschalls bei der Routineuntersuchung auf die intraventrikuläre Temperatur bei Patienten wurde untersucht. Material und Methoden: Patienten, die eine intrakranielle Druck- und Temperatursonde implantiert hatten und US untersucht wurden, werden eingeschlossen. In einer Untersuchungsserie (B-mode-, B- und Color-mode-, B- und Color-mode-plus-Doppler; jeweils für drei Minuten) wird der intrakranielle Thermistor der Messsonde fokussiert, während die intraventrikuläre Temperatur und die Körpertemperatur kontinuierlich (über Blasenkatheter oder rektal) gemessen werden. Die Temperaturänderungen werden analysiert. Ergebnisse: Bei 14 Patienten wurden 31 US durchgeführt. Für die Auswertung wurden 26 US bei 9 Patienten, bei denen die Temperatursonde dargestellt werden konnte, berücksichtigt. Die initialen Körpertemperaturen lagen zwischen 35,1 bis 38,7 °C. Es wurden keine signifikanten Temperaturänderungen während der ersten (B-mode), zweiten (B- und color) und dritten (b- und color plus Doppler) US gesehen. Der T-Test zeigte eine konstante Temperatur während der US (zweiseitige Signifikanz: 1,000; 1,000; 0,0731). Schlussfolgerung: Der transkranielle Routine-US erhöht die Hirntemperatur der Patienten nicht.
Abstract
Purpose: The effect of transcranial duplex ultrasound (US) on the intraventricular temperature in patients was analyzed. Temperature increases during examination have been identified as a potential risk factor but only data from model studies is currently available. Materials and Methods: Patients who had an intracranial pressure/temperature transducer implanted and underwent US assessment were included. In an examination series (B-mode, combined B- and color mode, combined B- and color mode plus Doppler, 3 min for each mode), the intracranial thermodilution thermistor was focused while intraventricular temperature and body temperature (bladder catheter or rectal probe) were recorded continuously and temperature changes were analyzed. Results: Thirty-one US examinations were performed in 14 patients. Twenty-six examinations in 9 patients in which the intracranial temperature probe was depicted were included. Initial patient temperatures ranged from 35.1dgC to 38.7dgC. No significant increase or decrease in intracranial temperature was seen after the first (B-mode), second (B- and color mode) and third (B- and color mode plus Doppler) duplex US examination. T-test for paired samples showed a constant temperature throughout US examination (two-sided significance: 1.000, 1.000, 0.731). Conclusion: Routine transcranial duplex ultrasound does not increase the intracranial temperature in patients.
Key words
ultrasonography - doppler - transcranial - safety
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Dr. Hans-Georg Schlosser
Department of Neurosurgery, Charité – Universitätsmedizin Berlin, Campus Virchow Klinikum (CVK)
Augustenburger Platz 1
13353 Berlin
Telefon: ++ 49/30/4 50 56 07 34
Fax: ++ 49/30/4 50 56 09 19
eMail: hans-georg.schlosser@charite.de
