Transcranial Color-Coded Sonography Criteria for Moderate and Severe Middle Cerebral Artery Stenosis

Ultrasound Med Biol. 2021 Jan;47(1):25-32. doi: 10.1016/j.ultrasmedbio.2020.09.008. Epub 2020 Oct 14.

Abstract

This study aimed to establish optimal criteria for evaluation of moderate (50%-69%) and severe (70%-99%) middle cerebral artery (MCA) stenosis with transcranial color-coded sonography (TCCS). A total of 375 cases provided 409 TCCS/digital subtraction angiography vessel pairs. Peak systolic velocity (PSV), end-diastolic velocity (EDV) and mean flow velocity (MFV) of the MCA were measured. The stenotic/distal MFV ratios (SDRs) were calculated. With digital subtraction angiography as a reference, for 50%-69% MCA stenosis, the optimal combined criteria were PSV ≥180 cm/s (sensitivity 95.7%, specificity 64.9% and overall accuracy 69.7%); EDV ≥75 cm/s (90.0%, 66.4% and 68.7%); MFV ≥110 cm/s (95.7%, 64.0% and 69.4%); and SDR ≥2.5 (88.6%, 71.3% and 76.3%). Criteria for 70%-99% MCA stenosis were PSV ≥240 cm/s (93.5%, 89.9% and 85.5%); EDV ≥100 cm/s (96.8%, 89.0% and 87.3%); MFV≥160 cm/s (91.9%, 92.8% and 92.2%); and SDR ≥4 (87.1%, 92.2% and 91.4%). Parameters of the MCA detected by TCCS, especially SDR, may increase accuracy in diagnosis of 50%-69% and 70%-99% MCA stenosis.

Keywords: Cerebral hemodynamic; Middle cerebral artery stenosis; Transcranial color-coded sonography; Ultrasound.

MeSH terms

  • Aged
  • Arterial Occlusive Diseases / diagnostic imaging*
  • Constriction, Pathologic
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Middle Cerebral Artery*
  • Retrospective Studies
  • Severity of Illness Index
  • Ultrasonography, Doppler, Color*
  • Ultrasonography, Doppler, Transcranial* / methods