Document Detail


Transcranial color-coded real-time sonographic criteria for occlusion of the middle cerebral artery in acute ischemic stroke.
MedLine Citation:
PMID:  15569730     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Transcranial color-coded real-time sonography (TCCS) is a useful tool to evaluate disease of the middle cerebral artery (MCA). This study was undertaken to identify TCCS criteria for the diagnosis of MCA stem and MCA branch occlusions. METHODS: TCCS and digital subtraction angiography were performed in 55 consecutive patients with acute stroke: 10 with MCA stem occlusion, the MO group; eight with MCA branch occlusion, the MB group; and 37 with nonocclusive lesions, the control group. We measured the end-diastolic velocity (EDV) of the bilateral MCA stems and calculated the end-diastolic ratio by dividing the EDV of the unaffected side by that of the affected side. RESULTS: EDV was highest in the control group, and end-diastolic ratio was highest in the MO group. An EDV of >25 cm/s indicated a nonocclusive lesion in the MCA, with a positive predictive value of 98.4%, a negative predictive value of 81.0%, and an accuracy of 93.9%. An EDV of <or=25 cm/s with an end-diastolic ratio of <2.7 indicated an MCA branch occlusion with a positive predictive value of 85.7%, a negative predictive value of 97.2%, and an accuracy of 95.3%. An EDV of <or=25 cm/s with an end-diastolic ratio of >or=2.7 indicated MCA stem occlusion with a positive predictive value of 100%, a negative predictive value of 100%, and an accuracy of 100%. CONCLUSION: We developed TCCS criteria for the diagnosis of MCA diseases. MCA flow velocity detected by means of TCCS can help identify MCA stem occlusion as well as MCA branch occlusion.
Authors:
Toshiyasu Ogata; Kazumi Kimura; Makoto Nakajima; Kouichi Ikeno; Hiroaki Naritomi; Kazuo Minematsu
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  25     ISSN:  0195-6108     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:    2004 Nov-Dec
Date Detail:
Created Date:  2004-11-30     Completed Date:  2005-02-08     Revised Date:  2008-02-14    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1680-4     Citation Subset:  IM    
Affiliation:
Department of Medicine, Cerebrovascular Division, National Cardiovascular Center, Osaka, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angiography, Digital Subtraction
Blood Flow Velocity
Brain Ischemia / complications*
Case-Control Studies
Cerebral Angiography
Computer Systems
Diastole
Female
Humans
Infarction, Middle Cerebral Artery / complications*,  physiopathology,  radiography,  ultrasonography*
Male
Middle Aged
Predictive Value of Tests
Sensitivity and Specificity
Stroke / etiology*,  ultrasonography*

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