The diagnostic accuracy of TCD for intracranial arterial stenosis/occlusion in patients with acute ischemic stroke: the importance of time interval between detection of TCD and CTA

Guan, Jingxia; Zhou, Qin; Ouyang, Huangqing; Zhang, Shaofeng; Lu, Zuneng

doi:10.1179/1743132813y.0000000230

Cited by 32 publications

(26 citation statements)

References 22 publications

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“…Therefore, the results of our study using TCD ultrasonography could have more reliability according to the results of the previous study regarding the usage of TCD for diagnosing ICAS. 15 In addition, greatest advantage of TCD in the setting like our study is the noninvasive character of the method without any radiation exposure.…”

Section: Discussionmentioning

confidence: 99%

“…In a recent study performed in Chinese patients, the authors prospectively compared the diagnostic accuracy of TCD ultrasonography as an additional screening tool for ICAS with that of computed tomographic angiography in patients with acute ischemic stroke. 15 They found that TCD ultrasonography demonstrated higher diagnostic accuracy than computed tomographic angiography, especially for middle cerebral artery, suggesting that TCD ultrasonography could be an alternative diagnostic tool to detect ICAS. Therefore, the results of our study using TCD ultrasonography could have more reliability according to the results of the previous study regarding the usage of TCD for diagnosing ICAS.…”

Section: Discussionmentioning

confidence: 99%

“…13 Although the accuracy of TCD ultrasonography in measuring the degree of stenosis varies among reported studies, it is advantageous for detecting ICAS because it provides realtime flow information in contrast to static imaging methods, such as computed tomographic angiography or magnetic resonance angiography. 14,15 Coronary artery calcification (CAC) is a surrogate marker for subclinical atherosclerosis and is known from previously reported studies to reflect atherosclerotic burden. 16,17 Increased coronary artery calcium score (CACS) is known to correlate with the risk of cardiovascular disease and various metabolic diseases.…”

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confidence: 99%

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Increased Risk for Intracranial Arterial Stenosis in Subjects With Coronary Artery Calcification

Chung

Rhee³

2015

Stroke

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Increased Risk for Intracranial Arterial Stenosis in Subjects With Coronary Artery Calcification

Chung

Rhee³

2015

Stroke

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“…The examination results indicate that TCD and CTA have good consistency in the detection of intracranial stenosis, especially in the case of MCA, and the results are consistent with those in Guan Jingxia's research. [17] In this paper, the statistical analysis results show that the rate of compliance is lower than that of the anterior circulation, which is related to the anatomical structure of vertebral artery and basilar artery. All the cases in our research were diagnosed as LAA, which carries higher incidence rate of vascular stenosis as well as detection rate.…”

Section: Discussionmentioning

confidence: 99%

The application value of TCD combined with CDUS in the large artery atherosclerosis

Wang¹,

Wang²,

Huang³

2015

DCC

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Objective: To explore the value of TCD and CDUS on diagnosis of large artery atherosclerosis. Methods: In our study, 90 patients who had been admitted to our hospital and diagnosed as LAA according to CISS typing were selected as the research object. A retrospective analysis was conducted, using CTA as golden standard for diagnoses of stenoses. Explore the risk factors of LAA, the reliability of TCD and CDUS in diagnosis of the stenosis and distribution of stenosis in each vessel. Results: Hypertension and type 2 diabetes are risk factors of LAA vascular stenosis. Middle cerebral artery stenosis detection by TCD carries the highest reliability (sensitivity 90.91%, specificity 97.89%, positive predictive value 96.15%, the negative predictive value was 94.9%, the positive likelihood ratio was 43.18, negative likelihood ratio 0.09, Kappa = 0.9). The consistency of TCD is as good as CTA in head and neck part. The negative coincidence rate was higher in the anterior circulation vessels (97.98%), followed by the coincidence rate of severe stenosis (95.23%). However, the detection rate of posterior circulation vessels positive, moderate and severe stenosis, mild stenosis gradually decreased by TCD. CDUS carries general reliability in detecting intracranial extracranial stenosis, the highest reliability in internal carotid artery (kappa 0.82), and the worst consistency in vertebral artery (kappa 0.38). The negative coincidence rate of CDUS in extracranial cerebrovascular stenosis was highest (97.22), followed by the overall compliance rate (91.55%). 242 branches of vascular stenosis were discovered in our study, among which intracranial artery stenosis 61.15% (148/242) is higher than that in extracranial artery 38.85% (90/242), ratio of moderate to severe stenosis is as high as 82. 23% (199/242). Intracranial artery stenosis in ICA is extremely common (51.11%, 46/90), and MCA is the common area of intracranial artery stenosis (37.16%, 55/148). Conclusions: (1) Hypertension, type 2 diabetes are risk factors for LAA stenosis. (2) TCD detection of intracranial vascular stenosis carries the best consistency, and reliability of MCA is the highest. In our search, MCA possesses the highest rate of stenosis, and negative coincidence rate by TCD examination was the highest, which could be used for screening method for stenosis. The reliability of TCD in diagnosis of moderate and severe stenosis was relatively better than mild stenosis. (3) CDUS detection of anterior circulation lesions is better than that of posterior circulation lesions. Evaluate effect on moderate and severe stenosis was better than that of mild one. The ratio of ICA stenosis was the highest, but the effect on VA was poor. (4) The incidence of intracranial vascular stenosis is more common than that of the intracranial vascular stenosis.

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“…33 CTA is considered the gold standard when evaluating TCD for occlusion detection. TCD is only able to detect skull base/proximal occlusions and has limited accuracy 34 when compared with CTA as the gold standard 35 but can be complementary to CTA in the acute setting given the dynamic nature of stroke where changes in occlusion status can occur quickly. 36,37 With the advent of endovascular treatment, there has been increasing attention given to understanding recanalization rates with treatments, such as intravenous thrombolysis, to determine when endovascular treatment is necessary.…”

Section: Occlusion Detection and Thrombus Lengthmentioning

confidence: 99%

Comparing Vessel Imaging

Demchuk

Menon

Goyal

2016

Stroke

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The diagnostic accuracy of TCD for intracranial arterial stenosis/occlusion in patients with acute ischemic stroke: the importance of time interval between detection of TCD and CTA

Cited by 32 publications

References 22 publications

Increased Risk for Intracranial Arterial Stenosis in Subjects With Coronary Artery Calcification

Increased Risk for Intracranial Arterial Stenosis in Subjects With Coronary Artery Calcification

The application value of TCD combined with CDUS in the large artery atherosclerosis

Comparing Vessel Imaging

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