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Transcranial Doppler findings in middle cerebral arterial occlusive disease in relation to degree of stenosis and presence of concomitant stenoses
Author(s) -
Bang Oh Young,
Cho Jeong Hoon,
Han Byung In,
Joo In Soo,
Kim Dong Ik,
Huh Kyoon
Publication year - 2003
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.10150
Subject(s) - medicine , middle cerebral artery , stenosis , transcranial doppler , concomitant , radiology , lesion , angiography , infarction , cardiology , ischemia , surgery , myocardial infarction
Abstract Purpose We evaluated the accuracy of transcranial Doppler (TCD) criteria in detecting middle cerebral artery (MCA) stenoses other than solitary severe stenoses. Methods Three TCD criteria were evaluated in patients with acute MCA territory infarction who also underwent angiography: abnormalities in mean velocity (MV), focal areas of spectral waveform abnormalities, and compensatory increase in MV in collateral vessels. Results Among 102 patients studied, angiography revealed MCA lesions in 48: 16 had uncomplicated lesions (single stenosis of moderate to severe degree), 19 had mildly complicated lesions (single MCA stenosis of other than moderate to severe degree, or moderate to severe MCA stenosis with a concomitant lesion outside the MCA), and 13 had severely complicated lesions (MCA stenosis of other than moderate to severe degree with a concomitant lesion outside the MCA). The sensitivity of abnormalities in MV in uncomplicated MCA lesions was 81%, whereas it was 53% in mildly complicated MCA lesions and 38% in severely complicated MCA lesions. However, a compensatory increase in MV in collaterals was more frequently found in complicated MCA lesions, and focal areas of spectral waveform abnormalities were observed fairly consistently in all groups. Conclusions TCD findings of focal areas of spectral waveform abnormalities and compensatory collateral flow were common in complicated MCA lesions and may improve the specificity of TCD in the diagnosis of MCA stenosis. © 2003 Wiley Periodicals, Inc. J Clin Ultrasound 31:142–151, 2003