Document Detail

Ultrasound velocity criteria for vertebral origin stenosis.
MedLine Citation:
PMID:  18681927     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Despite remaining an important cause of posterior circulation stroke, the non-invasive diagnosis of vertebral artery origin (VAo) stenosis is problematic. We here examine peak systolic velocity (PSV) criteria for the diagnosis of VAo stenosis and assess if the PSV ratio at the origin to the distal segments improves diagnostic accuracy. METHODS: We performed a retrospective analysis of patients studied by catheter cerebral angiography and extracranial Duplex ultrasonography. The angiographic degree of stenosis, PSV at the VAo, proximal vertebral artery (VA1), and intra-foraminal (VA2) segment were recorded. We calculated the VAo/VA1 and VAo/VA2 PSV ratio. A receiver operator curve was obtained (ROC) and the area under the curve (AUC) was compared for three different diagnostic criteria: PSV VAo, VAo/VA1, and VAo/VA2 PSV ratio. RESULTS: A total of 386 vertebral arteries were angiographically examined and VAo stenosis 50-99% was found in 36 (9%) vessels. The PSV VAo was the most accurate diagnostic parameter with an AUC .821 +/- .052 (SE) (CI: .72, .92). A PSV of 114 cm/second maximized sensitivity (71%) and specificity (90%). CONCLUSION: Our results support the use of PSV as a diagnostic criterion for VAo stenosis compared to a PSV ratio of VAo/V1 and VAo/V2.
Sebastian Koch; Jose G Romano; Hannah Park; Murtaza Amir; Alejandro M Forteza
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Publication Detail:
Type:  Journal Article     Date:  2008-08-04
Journal Detail:
Title:  Journal of neuroimaging : official journal of the American Society of Neuroimaging     Volume:  19     ISSN:  1552-6569     ISO Abbreviation:  J Neuroimaging     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-14     Completed Date:  2009-10-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102705     Medline TA:  J Neuroimaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  242-5     Citation Subset:  IM    
Department of Neurology, Miller School of Medicine, University of Miami, FL, USA.
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MeSH Terms
Area Under Curve
Cerebral Angiography
ROC Curve
Retrospective Studies
Sensitivity and Specificity
Ultrasonography, Doppler, Transcranial
Vertebral Artery / ultrasonography
Vertebrobasilar Insufficiency / diagnosis*,  ultrasonography*

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