Clinical usefulness of transcranial Doppler ultrasonography for the diagnosis of vascular occlusive lesions in ischemic cerebrovascular disease.
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In order to assess the usefulness of transcranial Doppler ultrasonography (TCD) in ischemic cerebrovascular disease, we investigated the rate of successful recording of blood flow signals from the middle cerebral artery (MCA) and tried to establish a tentative criterion for the diagnosis of the occlusive lesions in the MCA or the internal carotid artery (ICA). Although the rate of successful recording decreased with advancing age especially in the females, blood flow signals were recorded satisfactorily in 645 (76.8%) out of 840 MCAs of 420 patients studied and the rate of successful measurement from both sides of MCA was 70.5% (296 of 420 patients).<BR>In 18 healthy volunteers, a 95 percent confidence interval of the flow velocity of MCA was defined as a normal range and based on this, we determined following four abnormal flow velocity criteria; a) the peak flow velocity of MCA (MCAPF) ≥127 cm/sec, b) MCAPF ≤53 cm/sec, c) Turbulent flow, and d) MCAPF ratio between both MCAs≥1.34. By using these signs, we investigated the diagnostic accuracy of TCD for detecting occlusive lesions of the MCA or ICA in 61 patients with both TCD and angiographic examinations. The diagnostic accuracy for 17 patients with occlusion or stenosis of unilateral ICA was 84% by using the criterion [b) and d)] and that for 9 patients with stenosis of unilateral MCA was 89% by the criterion [a) or c)].<BR>In conclusion, TCD has been successfully applied for detecting flow signals from the MCAs of many Japanese patients except elderly females and by using a tentatively established abnormal flow velocity criterion TCD proved to be a quite useful and accurate method for the diagnosis of the occlusive MCA or ICA lesions.
- 一般社団法人 日本脳卒中学会の論文
一般社団法人 日本脳卒中学会 | 論文
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