Document Detail

Transcranial Doppler correlation with angiography in detection of intracranial stenosis.
MedLine Citation:
PMID:  7916499     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: The purpose of this study was to evaluate the use of velocity criteria applied to transcranial Doppler (TCD) signals in the detection of stenosis of the middle cerebral (MCA), distal vertebral, and basilar arteries. METHODS: Sixty-five patients who underwent both cerebral angiography and transcranial Doppler examinations in the workup of acute cerebral ischemia were reviewed. Angiography was performed a mean of 7 +/- 5 days (range, 1 to 28 days) after TCD. Interpretation of the angiogram was performed without input regarding the TCD findings. TCD interpretation was performed according to standard criteria. RESULTS: When we used a mean velocity (MV) cutoff of > or = 80 cm/s in the MCA as the criterion for stenosis, 10 of 12 stenoses of any degree were detected by TCD, with 11 of 87 false-positives. Nine of 12 MCA stem (M1) stenoses were detected when a cutoff of > or = 90 cm/s was used, with 7 of 87 false-positives. When we used an MV cutoff of > or = 70 cm/s as the criterion for > or = 50% stenosis of the vertebrobasilar system, 5 of 6 stenoses were detected, with 15 of 85 false-positives. The most important confounding factor was the presence of > or = 75% stenosis of the extracranial internal carotid artery, resulting in both false-positive (from collateral flow) and false-negative (decreased volume flow from the proximal stenosis without adequate collateral flow) errors in TCD interpretation. When patients with > or = 75% stenosis of the cervical internal carotid artery were excluded from analysis, a TCD MV cutoff of > or = 80 cm/s identified 9 of 10 M1 lesions with 7 of 61 false-positives, and an MV of > or = 70 cm/s identified 3 of 4 vertebrobasilar lesions causing > or = 50% stenosis with 7 of 56 false-positives. CONCLUSIONS: TCD may be an effective screening test for M1 stenosis when velocity criteria alone are used. TCD may less reliably detect intracranial vertebral and basilar artery stenosis.
M B Rorick; F T Nichols; R J Adams
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  25     ISSN:  0039-2499     ISO Abbreviation:  Stroke     Publication Date:  1994 Oct 
Date Detail:
Created Date:  1994-10-20     Completed Date:  1994-10-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1931-4     Citation Subset:  IM    
Department of Neurology, Case Western Reserve University, Cleveland, Ohio.
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MeSH Terms
Angiography, Digital Subtraction
Basilar Artery / radiography*,  ultrasonography*
Blood Flow Velocity
Brain Ischemia / radiography,  ultrasonography
Carotid Artery, Internal / radiography,  ultrasonography
Carotid Stenosis / radiography,  ultrasonography
Cerebellum / blood supply
Cerebral Angiography*
Cerebral Arterial Diseases / radiography*,  ultrasonography*
Cerebral Arteries / ultrasonography
Cerebrovascular Circulation
Constriction, Pathologic / radiography,  ultrasonography
Middle Aged
Sensitivity and Specificity
Ultrasonography, Doppler, Transcranial* / methods
Vertebral Artery / radiography*,  ultrasonography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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