| Cerebrovascular reserve in patients with carotid occlusive disease assessed by stable xenon-enhanced ct cerebral blood flow and transcranial Doppler. | |
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MedLine Citation:
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PMID: 11486110 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: Cerebrovascular reserve (CVR) by both transcranial Doppler ultrasonography (TCD) and quantitative cerebral blood flow (CBF) can identify subgroups of patients at increased risk for stroke. A direct comparison of CVR measurements obtained with both technologies in patients with cerebrovascular occlusive disease is lacking. METHODS: CVRs before and after acetazolamide administration (1 g IV) were measured by TCD insonation of the middle cerebral artery (MCA) and CBF obtained with stable xenon CT (Xe/CT) in 38 patients with carotid occlusive disease. Sensitivity/specificity calculations were based on 2 Xe/CT MCA values: an average over 4 levels and the level with the lowest percent change in CBF. Compromised CVR was defined as no reactivity or a decrease in reactivity. RESULTS: Using the analysis of the systolic TCD, we found that velocity changes compared with the average Xe/CT MCA CVR showed a sensitivity of 33%, specificity of 90.6%, positive predictive value of 54.5%, and negative predictive value of 80%. The sensitivity of TCD compared with the lowest Xe/CT CBF CVR was 35.5%, specificity and positive predictive values were 100%, and negative predictive value was 66.7%. The index of validity was between 72% and 76%. CONCLUSIONS: TCD is much less sensitive than Xe/CT CBF in identifying patients with compromised CVR. This may be a result of the inability of TCD to identify patients with compromised reserves when their MCA blood flow comes from collateral sources. The lack of correlation between TCD and Xe/CT CBF for identifying patients with compromised CVR should be considered when stroke risk assessments are made by TCD. |
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Authors:
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R R Pindzola; J R Balzer; E M Nemoto; S Goldstein; H Yonas |
Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Stroke; a journal of cerebral circulation Volume: 32 ISSN: 1524-4628 ISO Abbreviation: Stroke Publication Date: 2001 Aug |
Date Detail:
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Created Date: 2001-08-03 Completed Date: 2001-08-30 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: United States |
Other Details:
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Languages: eng Pagination: 1811-7 Citation Subset: IM |
Affiliation:
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Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. pindzola@neuronet.pitt.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acetazolamide
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diagnostic use Aged Aged, 80 and over Blood Flow Velocity Brain / blood supply, physiopathology, radiography Carotid Artery Diseases / diagnosis*, physiopathology Cerebrovascular Circulation* Female Humans Male Middle Aged Middle Cerebral Artery / physiopathology, ultrasonography Predictive Value of Tests Reproducibility of Results Sensitivity and Specificity Tomography, X-Ray Computed* / methods Ultrasonography, Doppler, Transcranial* Vasodilator Agents / diagnostic use Xenon / diagnostic use* |
| Grant Support | |
ID/Acronym/Agency:
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1-K01 HL-03851-01/HL/NHLBI NIH HHS; R03 HS09021-01/HS/AHRQ HHS |
| Chemical | |
Reg. No./Substance:
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0/Vasodilator Agents; 59-66-5/Acetazolamide; 7440-63-3/Xenon |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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