The value of transcranial Doppler derived pulsatility index for diagnosing cerebral small-vessel disease

Abstract

Background:The pulsatility index (PI), measured by transcranial Doppler (TCD) ultrasonography, can reflect vascular resistance induced by cerebral small-vessel disease (SVD). We evaluated the value of TCD-derived PI for diagnosing SVD as compared with magnetic resonance imaging (MRI).Materials and Methods:Fifty-six consecutive cases with SVD (based on MRI) and 48 controls with normal MRI underwent TCD. Based on MRI findings, patients were categorized into five subgroups of preventricular hyperintensity (PVH), deep white matter hyperintensity (DWMH), lacunar, pontin hyperintensity (PH), and PVH+DWMH+lacunar. The sensitivity and specificity of TCD in best PI cut-off points were calculated in each group.Results:The sensitivity and specificity of TCD in comparison with MRI with best PI cut-off points were as follows: In PVH with PI = 0.83, the sensitivity and specificity was 90% and 98%, respectively. In DWMH with PI = 0.79, the sensitivity and specificity was 75% and 87.5%, respectively. In lacunar with PI = 0.80, the sensitivity and specificity was 73% and 90%, respectively. In PH with PI = 0.69, the sensitivity and specificity was 92% and 87.5%, respectively. And, in PVH+DWMH+lacunar subgroup with PI = 0.83, the sensitivity and specificity was 90% and 96%, respectively.Conclusions:Increased TCD derived PI can accurately indicate the SVD. Hence, TCD can be used as a non-invasive and inexpensive method for diagnosing SVD, and TCD-derived PI can be considered as a physiologic index of the disease as well.

Use of a Doppler‐Based Pulsatility Index to Evaluate Cerebral Hemodynamics in Neurocritical Patients After Hemicraniectomy

“…First, apart from an ICP elevation, many factors affect MCA PI‐induced CVR changes. For example, Ghorbani et al showed that the MCA PI was associated with cerebral small‐vessel disease. Stretti et al found that body temperature affected cerebral hemodynamics; an elevated temperature induced cerebrovascular relaxation associated with a reduced CVR but an increased ICP attributable to cerebral hyperemia.…”

Risk of ischemic stroke during the initiation period of α-blocker therapy among older men

“…Further research is needed to determine whether the same findings would be observed in other ethnic populations. In addition, studies investigating the value of transcranial Doppler examination in the diagnosis of intracranial carotid artery stenosis 28,29 and guidance of α-blocker therapy are warranted.…”

Predictive value of transcranial doppler ultrasound for cerebral small vessel disease in elderly patients

“…In addition, TCD ultrasound can effectively assess the cerebral blood flow velocity of intracranial blood vessels in patients with sickle cell disease, stroke or brain death 14 . The pulsatility index, a parameter of TCD ultrasound, has been used for many years to reflect the resistance of small vessels 15,16,17 . This study aimed to investigate the relationship between the pulsatility index in TCD ultrasound and cerebral small vessel disease in elderly patients.…”