|
|
|
The Center's Know-How
1. A clinical interpretation of ultrasound Dopplerography
of cerebral arteries and veins. An absolutely new technique of ultrasound
investigation of cerebral arteries and veins which has been developed
and tested by neurosurgeons at Kyiv Emergency Hospital and certified
by the State Patent of Ukraine as "The method of ultrasound investigation
of the cerebrovascular condition" (The patent of the State Patent
of Ukraine N 10262 A issued 19th of July 1995).
2. Acoustic densitometry
A device which is a new stage in the development of medical equipment
has been elaborated.
The device works as an ultrasound microscope in vivo and provides
4 up to 32 coloured histological image.
It gives possibility to estimate tissue's acoustic density with
the help of 4 up to 32 gradational colouring different tissues and
enables tissue microcirculation visualisation. With the help of
the device a doctor can objectify fatty hepatosis and cirrhosis,
edema of different organs and tissues as well as microcirculation
in organs and tissues (e.g. muscles, myocard and bone system).
New promising applications of ultrasound systems in diagnostics
and for choosing individual treatment tactics, with pathogenesis
being taken into account, may be developed with the help of the
device.
Practical importance of the USDG veins and arteries
technique:
- As a result, venous and arterial hemodynamic parametres of the
cerebral system having no analogues were established and elaborated
with the help of ultrasound investigation techniques which enabled
us to study:
- passableness of the cerebral arteries and veins;
- elasticotonic properties of arteries and veins;
- reorganization of arterial and venous circulation;
- adaptative properties of venous colateral circulation;
- selection of effective pathogeneticly grounded medicinal
agents;
- prognosis of the cerebrovascular disease course in dependence
on arterial and venous cerebral reorganization in dynamics.
- Investigations of the cerebral hemodynamic condition performed
by us (ultrasound investigation and angiography of cerebral vessels)
have enabled us:
- to objectify the patient complaints at the early stages
of a disease in out- and in- patients;
- to reveal extra variants of clinical features of a cerebrovascular
pathology;
- to study compensatory opportunities of the cerebral hemodynamics
and their realization at different disease stages taking into
account the age aspect;
- to study the extent of cerebral hemodynamic reorganization
and recovery of neurologic deficiency under the influence
of medicinal agents and angioreconstructive operations;
- to study the clinical neurologic status in dynamics and
parameters of instrumental techniques of investigation in
patients at the early and distant periods of treatment.
- The revealed regularities of the arterial venous cerebral blood
supply depending on age and body position enabled us to recommend
the body position for a patient at the moment of crisis.
- We have elaborated neurological and instrumental criteria for
indication of surgical correction of cerebrovascular disturbances
and have grounded the prognosis of a disease at different stages
including the postoperational period.
- On the basis of the research performed, we have grounded a
choice of treatment tactics in patients with cerebrovascular pathology
depending on character of vessels' changes at different life periods.
- We have revealed the type and the rate of the age-specific
cerebral blood supply changes encouraging cerebrovascular diseases.
Scientific novelty of the results obtained:
- The techniques of venous cerebral channel ultrasound Doppler
allowing to consider the cerebrovascular disease pathogenesis
in a new way have been offered for the first time (the Patent
of State Patent of Ukraine N 10262 A issued on 19th of July, 1995).
- We have discovered new ways of using ultrasound investigation
in studying cerebral hemodynamic conditions not only in arteries
but, that has never been done before, in veins as well. In particular,
in such way we can study:
- elasticotonic properties of arteries and veins;
- passableness of vessels;
- the presence of a loopformation and vascular extravasal
compression;
- the condition of the arterial and venous collateral circulation;
- functioning of venous collectors;
- the level of the intracranial pressure;
- the causes of interruptions of cerebral arterial circulation.
- Combining above stated possibilities of the cerebral ultrasound
investigation with other techniques such as REG, EchoEG, and EEG,
we had an opportunity to learn the participation and specific
gravity of different parts of cerebral and brain hemodynamic in
a general bank of coordinating control that created theoretical
preconditions for development of the pathogenetic and individual
therapeutic medicamental or even neurosurgical programs and measures.
- Cerebrovascular deficiency characteristics in acute brain circulation
disturbance and discirculatory encephalopathy patients have been
developed on the basis of complex clinico-instrumental inspections.
The results of such complex inspections allow us to establish
the indexes for prognosis of cerebrovascular disease dynamics
individually for every patient.
- For the first time a complex inspection of brain arteries and
veins, namely ultrasound investigation, brain CT and MRI, angiography
of cerebral vessels, EEG, EchoEG, ECG of differently aged patients
with cerebrovascular pathologies has been carried out. Their state
influenced by medicines and the performed surgical treatment was
observed in dynamic. The hemodynamic regularities of the brain
vascular system's reorganisation under the influence of medicinal
factors and rebuilding operations in patients with cerebrovascular
diseases were studied as well.
- For the first time, the hemodynamic variants of different cerebrovascular
diseases in the age aspect were allocated. On the basis of the
objective analysis of a cerebral venous hemodynamic conditions
we proved its influence on formation of a cerebrovascular pathology.
- The model of the cerebrovascular disease pathogenesis in the
ontogenetic aspect was offered. A basis for the model was the
concept of the cerebral arteriovenous balance. The disturbances
of the balance in most cases resulted in cerebrovascular disease.
Approbation
The criteria elaborated for theultrasounddiagnostics and treatment
have been introduced in neurological and neurosurgical branch
establishments in regional associations of Kyiv and other cities
of Ukraine.
Taking into account a high informative function and reliability
combined with non-invasive techniques and possibilities of several
observations in dynamics, the method of ultrasound arterial venous
cerebrovascular investigation deserves recognition and wide application
in preclinical diagnostics of cerebrovascular pathologies. Mobility
and comparative inexpensiveness of the equipment for a cerebrovascular
ultrasound investigation combined with a high informative function
and promising possible application in angioreconstructive operations
with the appropriate software gives a positive prognosis for wide
introduction of this technique in different modifications in medical
practice of scientific research institutes as well as regional
hospitals.
top
|
