Diagnostic Values of Transcranial Doppler Ultrasound
Detecting High-grade Carotid Stenosis

J Korean Neurol Assoc > Volume 16(6); 1998 > Article

Journal of the Korean Neurological Association 1998;16(6): 781-787.

내경동맥 고도 협착 진단에 대한 경두개 초음파의 유용성

최선아, 손영호

연세대학교 의과대학 신경과학교실 및 뇌연구소

Diagnostic Values of Transcranial Doppler Ultrasound Detecting High-grade Carotid Stenosis

Sun- Ah Choi, M.D., Young Ho Sohn, M.D.

Department of Neurology and Brain Research Institute, Yonsei University College of Medicine

Abstract

Background: Transcranial Doppler Ultrasonography (TCD) is a non-invasive and easily applicable method to evaluate cerebral hemodynamics. The objective of this study is to evaluate the diagnostic value of TCD parameters detecting high-grade extracranial carotid stenosis.
Methods: The subjects were 17 patients who showed high-grade carotid stenosis (>75%) or occlusion on cerebral digital subtraction angiography (DSA) and 18 patients whose DSA were normal. TCD parameters were reversed ophthalmic artery flow (OR), reversed anterior cerebral arterial (ACA) flow (AR), increased flow velocity of contralateral ACA (>80cm/sec; CA), decreased flow velocity of ipsilateral MCA (<30cm/sec; IM), absence of ICA flow at siphon(IS), reduced flow acceleration (<280cm/sec2; FA) and pulsatility index (<0.5; PI) of MCA.
Results: The sensitivity of each parameter was 23.5% for OR, 47% for AR, 58.8% for CA, 5.9% for IM, 23.5% for IS, 70.6% for FA and 11.8% for PI, while their specificity was 100% in all parameters, except IS, 83.3%. When AR, CA and FA are combined, the sensitivity increased up to 86.7%.
Conclusions: Reduced flow acceleration of MCA and parameters related with collateral flow through the anterior communicating artery were proved to be more sensitive TCD parameters detecting high-grade extracranial carotid stenosis or occulsion than other parameters. Thus patients with abnormal TCD measurements of these parameters may need further evaluation for carotid disease. Key Words: Transcranial Doppler ultrasonography, Carotid artery, Cerebral angiography, Cerebral blood flow