Transcranial doppler ultrasonography versus arteriography for assessment of the vertebrobasilar circulation

Mull, Michael; Aulich, A.; Hennerici, Michael G.

doi:10.1002/jcu.1870180704

Cited by 36 publications

(11 citation statements)

References 15 publications

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“…Unfortunately, technical problems limit the validity of DS, especially for the diagnosis and exclusion of BAO. 5,7,8,18 Several studies confirmed the diagnostic value of some signs clearly indicating BAO, especially bilateral high-resistance flow patterns in the distal vertebral arteries and the proximal BA. [5][6][7]18 In our series, these signs were identified by DS in only 3 of 9 patients with proximal complete BAO.…”

Section: Discussionmentioning

confidence: 72%

CT Angiography and Doppler Sonography for Emergency Assessment in Acute Basilar Artery Ischemia

Brandt

Knauth

Wildermuth

et al. 1999

Stroke

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Background and Purpose-Both Doppler sonography (DS) and spiral CT angiography (CTA) are noninvasive vascular assessment tools with a high potential for application in acute cerebral ischemia. The usefulness of CTA for vascular diagnosis in acute basilar artery (BA) ischemia has not yet been studied. Methods-We prospectively studied 19 patients (meanϮSD age, 58Ϯ11 years) with clinically suspected acute BA occlusion by DS and CTA. Prior extracranial and transcranial DS was performed in all but 1 patient, with DS 4 hours after CTA. In 6 of 19 patients, we performed digital subtraction angiography. Results-CTA was diagnostic in all but 1 patient. CTA revealed complete BA occlusion in 9 patients and incomplete BA occlusion with some residual flow in 2 patients. A patent BA was shown in 7 patients. Because of severe BA calcification, CTA results were inconclusive in 1 patient. DS was diagnostic in only 7 of 19 patients, indicating certain BA occlusion in 3 patients and BA patency in 4 patients. In an additional 9 patients, the results of DS were inconclusive. DS was false-negative in 2 patients with distal BA occlusion shown by CTA and digital subtraction angiography. In 1 patient with DS performed after CTA, recanalization was demonstrated. In addition to the diagnosis or exclusion of BA occlusion, CTA provided information on the exact site and length of BA occlusion and collateral pathways. In our series, CTA results prompted indication for intra-arterial thrombolysis in 5 patients. Conclusions-CTA was superior to DS in the assessment of BA patency in patients with the syndrome of acute BA ischemia in terms of feasibility and conclusiveness, particularly in cases with distal BA occlusion. Our study confirmed the usefulness of combined extracranial and transcranial DS in the diagnosis and exclusion of proximal BA occlusion.

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Section: Discussionmentioning

confidence: 72%

CT Angiography and Doppler Sonography for Emergency Assessment in Acute Basilar Artery Ischemia

Brandt

Knauth

Wildermuth

et al. 1999

Stroke

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“…21 Combining continuous-wave Doppler ultrasound of the extracranial arteries and TCD of intracranial vertebrobasilar arteries in another study did not improve sensitivity. 22 Posterior circulation lesions may be missed as a result of inability to insonate the entire course of the vertebral and basilar arteries 23 or suboptimal angle of insonation, resulting in underestimation of MV. The use of transcranial color-coded real-time ultrasonography in our patients could have potentially allowed correction for Doppler angle to eliminate underestimation of velocities in stenotic lesions.…”

Section: Discussionmentioning

confidence: 99%

Transcranial Doppler correlation with angiography in detection of intracranial stenosis.

Rorick

Nichols

Adams

1994

Stroke

120

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Background and Purpose The purpose of this study was to evaluate the use of velocity criteria applied to transcranial Doppler (TCD) signals in the detection of stenosis of the middle cerebral (MCA), distal vertebral, and basilar arteries.Methods Sixty-five patients who underwent both cerebral angiography and transcranial Doppler examinations in the workup of acute cerebral ischemia were reviewed. Angiography was performed a mean of 7±5 days (range, 1 to 28 days) after TCD. Interpretation of the angiogram was performed without input regarding the TCD findings. TCD interpretation was performed according to standard criteria.Results When we used a mean velocity (MV) cutoff of a 80 cm/s in the MCA as the criterion for stenosis, 10 of 12 stenoses of any degree were detected by TCD, with 11 of 87 falsepositives. Nine of 12 MCA stem (Ml) stenoses were detected when a cutoff of >90 cm/s was used, with 7 of 87 falsepositives. When we used an MV cutoff of >70 cm/s as the criterion for >50% stenosis of the vertebrobasilar system, 5 of

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“…13,14 Stenosis and occlusion of the ICA siphon, proximal (M1) segment of the MCA, intracranial vertebral artery (VA), proximal basilar artery (BA), and proximal (P1) segment of the posterior cerebral artery (PCA) can be reliably detected by TCD. 1,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] The relative performance of TCD vs MRA, conventional angiography, or DSA varies by center, characteristics and prevalence of disease in the study population, diagnostic criteria, and technical expertise. Sensitivity, specificity, positive predictive value, and negative predictive value of TCD are generally higher in the anterior circulation than in the vertebrobasilar circulation owing to more variable anatomy and technical difficulties in insonation of the vertebrobasilar circulation.…”

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confidence: 99%

Assessment: Transcranial Doppler ultrasonography: [RETIRED]

et al. 2004

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Abstract-Objective:To review the use of transcranial Doppler ultrasonography (TCD) and transcranial color-coded sonography (TCCS) for diagnosis. Methods: The authors searched the literature for evidence of 1) if TCD provides useful information in specific clinical settings; 2) if using this information improves clinical decision making, as reflected by improved patient outcomes; and 3) if TCD is preferable to other diagnostic tests in these clinical situations. Results: TCD is of established value in the screening of children aged 2 to 16 years with sickle cell disease for stroke risk (Type A, Class I) and the detection and monitoring of angiographic vasospasm after spontaneous subarachnoid hemorrhage (Type A,

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Transcranial doppler ultrasonography versus arteriography for assessment of the vertebrobasilar circulation

Cited by 36 publications

References 15 publications

CT Angiography and Doppler Sonography for Emergency Assessment in Acute Basilar Artery Ischemia

CT Angiography and Doppler Sonography for Emergency Assessment in Acute Basilar Artery Ischemia

Transcranial Doppler correlation with angiography in detection of intracranial stenosis.

Assessment: Transcranial Doppler ultrasonography: [RETIRED]

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