Value of transcranial color Doppler in diagnosis of internal carotid artery severe stenosis or occlusion
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Objective To evaluate the value of TCD in diagnosis of internal carotid artery severe stenosis or occlusion. Methods Twenty-one patients with internal carotid artery severe stenosis or occlusion were examined by TCD,then DSA or MRA within one week. The results of TCD and DSA (or MRA) were compared. Results The sensitivity of TCD in diagnosis of carotid stenosis was 92.00% ,the specificity was 94.12%.The false positive rate was 5.88%. The false negative rate was 8.00% and the diagnostic accuracy was 92.86% . The accuracy of TCD in diagnosis of internal carotid artery severe stenosis or occlusion was 80.95%. The accuracy of TCD in diagnosis of stenosis degree was 69.23%. Conclusion TCD is able to be used as a screening method in diagnosis of internal carotid artery stenosis,but for judgement of internal carotid artery stenosis degree,TCD still has its limitations.Keywords:
Transcranial Doppler
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Objective To study the diagnostic value of TCD for cerebral artery stenosis and reasonable checking program.Methods 59 patients diagnosed ischemic cerebral vascular disease were studied in the department of neurology.They all took the examination in DSA and TCD,and the result was subgrouped into 5 groups,regulate the result of DSA as the standard,compute the specificity and sensibility of TCD in the diagnosis of cerebral artery stenosis.Results Arteries were consistent with middle cerebral arteries、internal carotid arteries、vertebral arteries、basilar arteries and subclavian arteries by DSA.Analysis shows that the sensibility and specificity of TCD in diagnosing the above groups are 89.47%、93.94%,57.89%、97.98%,68.75%、95.10%,90.00%、97.22%,100%、100%.Conclusion As the first method in screening of cerebral artery stenosis,TCD had higher specificity and sensitivity for the diagnosis of cerebral artery stenosis.
Transcranial Doppler
Anterior cerebral artery
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[Objective]To investigate the significance of transcranial doppler(TCD)used in the diagnosis of cerebral artery stenosis induced by hypertension or diabetes.[Methods]122 patients with cerebral artery stenosis induced by hypertension and/or diabetes were examined by TCD and Digital Subtraction Angiography(DSA). The changes of intracranial vascular were observed.[Results]1025 cerebral vessels were tested in these 122 patients. Among the 165 vessels with intracranial artery stenosis tested by TCD,the diagnoses of 129 vessels were the same as those by DSA. 16 intracranial arteries showed stenosis by DSA,which were normal by TCD. The sensitivity,specificity,positive predictive value and negative predictive value of TCD were 81.2%,93.6%,95.3% and 95.3%,respectively. TCD had the higher sensitivity and specificity for diagnosis of MCA and VA stenosis,but it had the lower sensitivity in ACA and PCA stenosis. The vascular stenosis rates in the patients with hypertension and diabetes increased significantly.[Conclusion]TCD had a higher sensitivity and specificity for diagnosis of intracranial artery stenosis,and it was more accuracy for diagnosis of MCA and VA stenosis than that of ACA and PCA.
Transcranial Doppler
Digital subtraction angiography
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Objective To explore the value of the diagnosis of middle cerebral artery （MCA） stenosis with transcranial Doppler ultrasound （TCD）. Methods The clinical data in patients with ischemic cerebrovascular disease examined with digital subtract angiography （DSA） and TCD were analyzed retrospectively. DSA was used as a gold standard to analyze the sensitivity and specificity of the diagnosis of MCA stenosis with TCD. The normal and TCD blood flow velocity with different deffees of stenosis were compared. The best cut-off point of the TCD blood flow velocity of MCA at different degree of stenosis was calculated. Results DSA confirmed that 103 patients had MCA stenosis or occlusion, in which 12 were mild stenosis, 22 were moderate stenosis, 40 were severe stenosis, and 39 were occlusion. Compared to DSA, the sensitivity of TCD in detection of moderate and severe MCA stenosis or occlusion was 78. 8%, the specificity was 96. 0%, and the accuracy was 93.0%, the missed diagnosis rate was 21.2%, and the misdiagnosis rate was 4. 0%. As to the blood flow velocity, there was no sifftificant difference between the mild stenosis and normal groups; while there was significant difference between the moderate stenosis and normal groups （/9 〈 0. 001）. In addition, there was no significant difference in blood flow velocity between the moderate stenosis and severe stenosis groups. Determining the cut-off value of the best peak systolic velocity of the moderate stenosis was 163.5 cm/s, while the best cut-off value of the mean velocity was 108.5 cm/s. Conclusions TCD has certain advantages in the diagnosis of the MCA stenosis or occlusion, and it can be used as a safe and inexpensive screening means before DSA examination.
Key words:
Intracranial arterial diseases; Ultrasonography, Doppler, transcranial; Angiography, digital subtraction; Middle cerebral artery; Blood flow velocity
Transcranial Doppler
Digital subtraction angiography
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Objective To evaluate the value of three dimensional digital subtraction angiography(3D-DSA),transcranial doppler sonography(TCD)and carotid ultrasonography in diagnosis of transient ischemic attack(TIA)in carotid artery system.Methods 3D-DSA,TCD and carotid ultrasonography examinations were performed in 63 patients with carotid disease,and then the abnormality of carotid artery system was analyzed.Results 3D-DSA abnormality of carotid artery was 18 cases(28.6%),cerebral artery abnormality was 48 cases(76.2%),and 12 cases were abnormal in both,while most of them showed mild-severe carotid artery stenosis;the abnormality of TCD was 45 cases(71.4%);and the abnormality of carotid ultrasonography was 24 cases(38.1%),in which 18 cases were carotid artery 3D-DSA abnormal.Conclusion United application of 3D-DSA,TCD and carotid ultrasonography can perform objective evaluation on the etiology and diagnosis of carotid disease.As the gold standard for the diagnosis and treatment of cerebral or carotid artery stenosis as well as selection of therapeutic regimen,DSA plays an impotant role in the further interventions of ischemic cerebrovascular disease.
Abnormality
Digital subtraction angiography
Carotid ultrasonography
Transcranial Doppler
Carotid artery disease
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Objective To analysis the disagreement between transcranial Doppler (TCD) and digital subtraction angiography (DSA) in patients with ischemic cerebrovascular diseases caused by intracranial artery stenosis or occlusion. Methods 120 patients with ischemic cerebrovascular diseases were tested by TCD and DSA, the results and the reason of the disagreement were analysed. Results 1304 arteries in 120 patients were examed by TCD, which showed 172 stenotic arteries,156 of which were confirmed with DSA. The sensitivity of TCD examinations for arterial stenosis was 85.7%.The specificity was 98.2%. The false positive rate was 9.3 % , the false negative rate was 2.3 % Conclusions TCD is an important and noninvasive methods for the diagnosis of intracranial artery stenosis. Because of some limits in detecting cerebral vasculature so there is difference in the result of TCD and DSA,Improving the diagnostic techniques can improve, the accuracy.
Digital subtraction angiography
Transcranial Doppler
Subtraction
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Objective: To observe the value of transcranial Doppler (TCD) in the diagnosis of intracranial artery stenosis in ischemic cerebrovascular disease. Methods: TCD and digital subtraction angiography (DSA) were performed in 128 inpatients with ischemic cerebrovascular disease. The changes of intracranial artery stenosis were observed. Results: 1112 cerebral vessels were tested in these 128 patients. Among the 183 vessels with intracranial artery stenosis tested by TCD, the diagnoses of 135 vessels were the same as those by DSA. Twenty-nine intracranial arteries showed stenosis by DSA, which were normal by TCD. The sensitivity, specificity, positive predictive value and negative predictive value of TCD were 82.3%, 94.9%, 73.7 %, and 96.8% respectively. TCD had the higher sensitivity and specificity for diagnosis of MCA and VA stenosis, but it had the lower sensitivity in ACA and PCA stenosis. Conclusion: TCD had a higher sensitivity and specificity for diagnosis of intracranial artery stenosis, and it was more accuracy for diagnosis of MCA and VA stenosis than that of ACA and PCA.
Transcranial Doppler
Digital subtraction angiography
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Objective:To investigate the value of carotid artery severe stenosis after endovascular stenting by Doppler sonography(TCD) and Color Doppler flow Imaging(CDFI).Methods:38 cases with carotid artery severe stenosis were examined after interventional therapy by TCD and CDFI,in order to evaluate the Carotid artery morphology and hemodynamic.Results:38 cases with the carotid artery stenosis and the degree of stenosis of more than 70%,after endovascular stenting,the diemeters increased,the blood velocity decreased,The stenosis disappeared,Open lateral branch closed,Hemodynamic the parameters improved significantly by TCD and CDFI,the results which were examined by TCD and CDFI were consistent with the results by digital subtraction angiography(DSA).Conclusion:Diagnosis by CDFI had the higher the accuracy of the carotid artery severe stenosis.TCD combined with CDFI improve the accuracy of the diagnosis about carotid artery severe stenosis and become a very important method for assessing and following up curative effect of carotid artery stent.
Digital subtraction angiography
Transcranial Doppler
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Objective:To analyse the changes of intracranial hemodynamics in patients with intracranial artery stenosis ≥70% or occlusion by TCD examination.Method:We evaluated the changes of 43 cases intracranial hemodynamics examined with TCD,who were diagnosed as internal carotid artery stenosis or occlusion with CTA.Result:The mean velocity and pulsatility index was lower in patients with severe carotid artery stenosis in MCA than those in normal group.While it was lowest in patients with carotid artery occlusion(P0.05).The opening of anterior and posterior communicating artery,internal and outernal carotid artery was 58.14%,48.84% and 44.19% respectively in collateral circulation.Conclusion:The examination of TCD and CTA proved the relation of collateral circulation with decrease of blood volume in the same side with severe internal carotid artery stenosis or occlusion
Collateral circulation
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Objective To evaluate the reliability of transcranial doppler(TCD)in diagnosing internal carotid artery, middle cerebral artery stenosis of cerebral infarction patients. Methods There were 45 patients with cerebral infarction who were treated in our department between 2011 June to 2012 August. They were underwent TCD and CTA examination within 1 week after hospitalization(time interval in 3 days). Results According to CTA results,the sensitivity of TCD in diagnosing internal carotid artery stenosis(occlusion, severe and moderate stenosis)was 47.1%, the specificity was93.2%, the coincidence was 84.4%;The sensitivity of TCD in diagnosing middle cerebral artery stenosis(occlusion, severe and moderate stenosis)was 40.9%, the specificity was86.8%,the coincidence was75.6%. Conclusion Diagnosis of internal carotid artery and middle cerebral artery stenosis with TCD has high specificity. Combination of TCD and CTA can improve the accuracy of the assessment of stenosis severity.
Transcranial Doppler
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Objective To study the image of color Doppler in severe stenosis and occlusion of internal carotid artery.(Methods Twenty)-eight arteries with atherosclerotic stenosis in 23 patients were analyzed.The findings were compared with those of MRA and DSA. Results Twenty-five arteries had severe stenosis and three occluded.Soft intravascular plaque was seen in 27 arteries and hard plaque in one artery,compared with 18 arteries in 15 cases for MRA,the coincidence was 86.7%;compared with 10 arteries in eight cases for DSA,the coincidence was 88.9%. Conclusion Color Doppler sonography has relatively high sensitivity and specificity in the diagnosis of severe stenosis and occlusion of internal carotid artery.
Color doppler
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