Document Detail

Absent middle cerebral artery signal in transcranial color-coded sonography: a reliable indicator of occlusion?
MedLine Citation:
PMID:  16123545     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Assess the accuracy of transcranial color-coded sonography (TCCS) for detecting middle cerebral artery (MCA) stem occlusion and compare it with cerebral angiography. METHODS: This study enrolled a series of patients who received TCCS and cerebral angiography at the Department of Neurology in Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, between January 1997 and July 2003. MCA stem occlusion was diagnosed based on digital subtraction angiography and/or computed tomographic angiography. The effect of the supplying artery on the insonation of MCA stem was considered. The sonographic criteria for MCA stem occlusion were defined as absent MCA stem signal + visible signal on the reference arteries, including ipsilateral posterior cerebral artery, ipsilateral anterior cerebral artery or contralateral MCA stem. RESULTS: A total of 419 consecutive patients were enrolled. Factors that significantly influenced MCA stem insonation included > or =50% ipsilateral carotid artery stenosis, > or =50% MCA stem stenosis, female gender, and age > or =60 years. Comparing patients with <50% and those with > or =50% carotid stenosis, the MCA stem insonation rate was significantly reduced from 69.1% to 45.6% (p < 0.001). In patients with <50% ipsilateral carotid artery stenosis, the sonographic criteria had a positive predictive value of 10.5% and a negative predictive value of 98.9%, and could predict MCA stem occlusion with high specificity but low sensitivity (specificity = 89.6, sensitivity = 54.5, overall accuracy = 88.9, p < 0.001). CONCLUSION: Absent MCA stem signal may result from MCA stem occlusion/tight stenosis and tight stenosis of ipsilateral carotid arteries, and has a limited value in detecting MCA stem occlusion. TCCS can be useful in identifying nonoccluded MCA stem, and cerebral angiography is necessary to confirm MCA stem occlusion.
Yi-Chun Chen; Sien-Tsong Chen; Chi-Jen Chen; Tsong-Hai Lee
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Validation Studies     Date:  2005-08-22
Journal Detail:
Title:  Cerebrovascular diseases (Basel, Switzerland)     Volume:  20     ISSN:  1015-9770     ISO Abbreviation:  Cerebrovasc. Dis.     Publication Date:  2005  
Date Detail:
Created Date:  2005-09-19     Completed Date:  2005-11-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9100851     Medline TA:  Cerebrovasc Dis     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  251-7     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2005 S. Karger AG, Basel.
Department of Neurology, Chang Gung Memorial Hospital, Lin-kou Medical Center, Kueishan, Taoyuan, Taiwan, ROC.
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MeSH Terms
Cerebral Angiography / standards
Infarction, Middle Cerebral Artery / ultrasonography*
Middle Aged
Predictive Value of Tests
Reproducibility of Results
Sensitivity and Specificity
Ultrasonography, Doppler, Transcranial / standards*

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