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    
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.
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    
Department of Medicine, Cerebrovascular Division, National Cardiovascular Center, Osaka, Japan.
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MeSH Terms
Angiography, Digital Subtraction
Blood Flow Velocity
Brain Ischemia / complications*
Case-Control Studies
Cerebral Angiography
Computer Systems
Infarction, Middle Cerebral Artery / complications*,  physiopathology,  radiography,  ultrasonography*
Middle Aged
Predictive Value of Tests
Sensitivity and Specificity
Stroke / etiology*,  ultrasonography*

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