Transcranial Doppler Ultrasonography for Diagnosis of Cerebral Vasospasm After Aneurysmal Subarachnoid Hemorrhage: Mean Blood Flow Velocity Ratio of the Ipsilateral and Contralateral Middle Cerebral Arteries
Abstract BACKGROUND: Transcranial Doppler (TCD) is widely accepted to monitor cerebral vasospasm after subarachnoid hemorrhage (SAH); however, its predictive value remains controversial. OBJECTIVE: To investigate the predictive reliability of an increase in the mean blood flow velocity (mBFV) ratio...
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| Veröffentlicht in: | Neurosurgery 2011-10, Vol.69 (4), p.876-883 |
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| creator | Nakae, Ryuta Yokota, Hiroyuki Yoshida, Daizo Teramoto, Akira |
| description | Abstract
BACKGROUND:
Transcranial Doppler (TCD) is widely accepted to monitor cerebral vasospasm after subarachnoid hemorrhage (SAH); however, its predictive value remains controversial.
OBJECTIVE:
To investigate the predictive reliability of an increase in the mean blood flow velocity (mBFV) ratio of the ipsilateral to contralateral middle cerebral arteries (I/C mBFV) compared with the conventional absolute flow velocity.
METHODS:
We retrospectively investigated the clinical and radiologic data of consecutive patients with SAH admitted from July 2003 to August 2009 who underwent TCD ultrasonography. The highest mBFV value in bilateral middle cerebral arteries was recorded, while delayed cerebral ischemia (DCI) was defined as neurological deficits or computed tomographic evidence of cerebral infarction caused by vasospasm. The ipsilateral side was defined as the side with higher mBFV value when evaluating the I/C mBFV. We thus elucidated the reliability of this rate in comparison with the conventional method for predicting DCI with receiver operating characteristic (ROC) analysis.
RESULTS:
One hundred and forty-two patients were retrospectively analyzed with specific data from 1262 TCD studies. The ROC curve showed that the overall predictive value for DCI had an area under the curve of 0.86 (95% confidence interval: 0.76-0.96) when the I/C mBFV was used vs 0.80 (0.71-0.88) when the absolute flow velocity was used. The threshold value that best discriminated between patients with and without DCI was I/C mBFV of 1.5.
CONCLUSION:
In patients with SAH, the I/C mBFV demonstrated a more significant correlation to vasospasm than the absolute mean flow velocity. |
| doi_str_mv | 10.1227/NEU.0b013e318222dc4c |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_888341178</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1227/NEU.0b013e318222dc4c</oup_id><sourcerecordid>888341178</sourcerecordid><originalsourceid>FETCH-LOGICAL-c470t-a23647e13f656d148709c9bae61a446db5b9b1dbd67129047aabb578f7c9fde33</originalsourceid><addsrcrecordid>eNqNkV9rFDEUxQdR7Fr9BiIBEZ-2TTKZSca3ddvaQqug3eLbcPNndlMyyZjMIPsp_Upm2a2FPvmSwM3vnBzuKYq3BJ8QSvnp1_PVCZaYlKYkglKqFVPPihmpKJszzPDzYoYJE_OyqX8eFa9SuseY1IyLl8URJVUlGl7Pij-3EXxS-bDg0FkYBmciWrkxQgo-rCMMmy3qQkRnFtY-JJtQ6NDSRCNjVtxlLA2QerToxqxceDPFberz049JQgS18cFqdGn6EOMG1uYTujHg0WcXgkYXLvxGd8YFZcct-g6jDTv7cWPQ1ZCsg-yZrcBrtAw-h3qY3FitnXnMsYh5bk16XbzowCXz5nAfF6uL89vl5fz625er5eJ6rhjH4xxomVdhSNnVVa3zmjhuVCPB1AQYq7WsZCOJlrrmhDaYcQApKy46rppOm7I8Lj7ufYcYfk0mjW1vkzLOgTdhSq0QomSEcJHJ90_I-zBFn8O1tKxqwStK6kyxPaViSCmarh2i7SFuW4LbXd9t7rt92neWvTuYT7I3-p_ooeAMfDgAkBS4LhetbHrkWMUaLnYpT_dcmIb_-_ovfLHHkg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2356875216</pqid></control><display><type>article</type><title>Transcranial Doppler Ultrasonography for Diagnosis of Cerebral Vasospasm After Aneurysmal Subarachnoid Hemorrhage: Mean Blood Flow Velocity Ratio of the Ipsilateral and Contralateral Middle Cerebral Arteries</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><creator>Nakae, Ryuta ; Yokota, Hiroyuki ; Yoshida, Daizo ; Teramoto, Akira</creator><creatorcontrib>Nakae, Ryuta ; Yokota, Hiroyuki ; Yoshida, Daizo ; Teramoto, Akira</creatorcontrib><description>Abstract
BACKGROUND:
Transcranial Doppler (TCD) is widely accepted to monitor cerebral vasospasm after subarachnoid hemorrhage (SAH); however, its predictive value remains controversial.
OBJECTIVE:
To investigate the predictive reliability of an increase in the mean blood flow velocity (mBFV) ratio of the ipsilateral to contralateral middle cerebral arteries (I/C mBFV) compared with the conventional absolute flow velocity.
METHODS:
We retrospectively investigated the clinical and radiologic data of consecutive patients with SAH admitted from July 2003 to August 2009 who underwent TCD ultrasonography. The highest mBFV value in bilateral middle cerebral arteries was recorded, while delayed cerebral ischemia (DCI) was defined as neurological deficits or computed tomographic evidence of cerebral infarction caused by vasospasm. The ipsilateral side was defined as the side with higher mBFV value when evaluating the I/C mBFV. We thus elucidated the reliability of this rate in comparison with the conventional method for predicting DCI with receiver operating characteristic (ROC) analysis.
RESULTS:
One hundred and forty-two patients were retrospectively analyzed with specific data from 1262 TCD studies. The ROC curve showed that the overall predictive value for DCI had an area under the curve of 0.86 (95% confidence interval: 0.76-0.96) when the I/C mBFV was used vs 0.80 (0.71-0.88) when the absolute flow velocity was used. The threshold value that best discriminated between patients with and without DCI was I/C mBFV of 1.5.
CONCLUSION:
In patients with SAH, the I/C mBFV demonstrated a more significant correlation to vasospasm than the absolute mean flow velocity.</description><identifier>ISSN: 0148-396X</identifier><identifier>EISSN: 1524-4040</identifier><identifier>DOI: 10.1227/NEU.0b013e318222dc4c</identifier><identifier>PMID: 21558976</identifier><identifier>CODEN: NRSRDY</identifier><language>eng</language><publisher>Hagerstown, MD: Oxford University Press</publisher><subject>Aged ; Aneurysms ; Biological and medical sciences ; Blood Flow Velocity ; Cerebrovascular Circulation - physiology ; Female ; Flow velocity ; Functional Laterality - physiology ; Humans ; Male ; Medical diagnosis ; Medical sciences ; Middle Aged ; Middle Cerebral Artery - diagnostic imaging ; Neurosurgery ; Predictive Value of Tests ; Retrospective Studies ; ROC Curve ; Stroke ; Subarachnoid Hemorrhage - complications ; Subarachnoid Hemorrhage - diagnostic imaging ; Subarachnoid Hemorrhage - physiopathology ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Ultrasonic imaging ; Ultrasonography, Doppler, Transcranial ; Vasospasm, Intracranial - diagnostic imaging ; Vasospasm, Intracranial - etiology ; Vasospasm, Intracranial - physiopathology ; Veins & arteries</subject><ispartof>Neurosurgery, 2011-10, Vol.69 (4), p.876-883</ispartof><rights>Copyright © 2011 by the Congress of Neurological Surgeons</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-a23647e13f656d148709c9bae61a446db5b9b1dbd67129047aabb578f7c9fde33</citedby><cites>FETCH-LOGICAL-c470t-a23647e13f656d148709c9bae61a446db5b9b1dbd67129047aabb578f7c9fde33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24549788$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21558976$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nakae, Ryuta</creatorcontrib><creatorcontrib>Yokota, Hiroyuki</creatorcontrib><creatorcontrib>Yoshida, Daizo</creatorcontrib><creatorcontrib>Teramoto, Akira</creatorcontrib><title>Transcranial Doppler Ultrasonography for Diagnosis of Cerebral Vasospasm After Aneurysmal Subarachnoid Hemorrhage: Mean Blood Flow Velocity Ratio of the Ipsilateral and Contralateral Middle Cerebral Arteries</title><title>Neurosurgery</title><addtitle>Neurosurgery</addtitle><description>Abstract
BACKGROUND:
Transcranial Doppler (TCD) is widely accepted to monitor cerebral vasospasm after subarachnoid hemorrhage (SAH); however, its predictive value remains controversial.
OBJECTIVE:
To investigate the predictive reliability of an increase in the mean blood flow velocity (mBFV) ratio of the ipsilateral to contralateral middle cerebral arteries (I/C mBFV) compared with the conventional absolute flow velocity.
METHODS:
We retrospectively investigated the clinical and radiologic data of consecutive patients with SAH admitted from July 2003 to August 2009 who underwent TCD ultrasonography. The highest mBFV value in bilateral middle cerebral arteries was recorded, while delayed cerebral ischemia (DCI) was defined as neurological deficits or computed tomographic evidence of cerebral infarction caused by vasospasm. The ipsilateral side was defined as the side with higher mBFV value when evaluating the I/C mBFV. We thus elucidated the reliability of this rate in comparison with the conventional method for predicting DCI with receiver operating characteristic (ROC) analysis.
RESULTS:
One hundred and forty-two patients were retrospectively analyzed with specific data from 1262 TCD studies. The ROC curve showed that the overall predictive value for DCI had an area under the curve of 0.86 (95% confidence interval: 0.76-0.96) when the I/C mBFV was used vs 0.80 (0.71-0.88) when the absolute flow velocity was used. The threshold value that best discriminated between patients with and without DCI was I/C mBFV of 1.5.
CONCLUSION:
In patients with SAH, the I/C mBFV demonstrated a more significant correlation to vasospasm than the absolute mean flow velocity.</description><subject>Aged</subject><subject>Aneurysms</subject><subject>Biological and medical sciences</subject><subject>Blood Flow Velocity</subject><subject>Cerebrovascular Circulation - physiology</subject><subject>Female</subject><subject>Flow velocity</subject><subject>Functional Laterality - physiology</subject><subject>Humans</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Middle Cerebral Artery - diagnostic imaging</subject><subject>Neurosurgery</subject><subject>Predictive Value of Tests</subject><subject>Retrospective Studies</subject><subject>ROC Curve</subject><subject>Stroke</subject><subject>Subarachnoid Hemorrhage - complications</subject><subject>Subarachnoid Hemorrhage - diagnostic imaging</subject><subject>Subarachnoid Hemorrhage - physiopathology</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography, Doppler, Transcranial</subject><subject>Vasospasm, Intracranial - diagnostic imaging</subject><subject>Vasospasm, Intracranial - etiology</subject><subject>Vasospasm, Intracranial - physiopathology</subject><subject>Veins & arteries</subject><issn>0148-396X</issn><issn>1524-4040</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkV9rFDEUxQdR7Fr9BiIBEZ-2TTKZSca3ddvaQqug3eLbcPNndlMyyZjMIPsp_Upm2a2FPvmSwM3vnBzuKYq3BJ8QSvnp1_PVCZaYlKYkglKqFVPPihmpKJszzPDzYoYJE_OyqX8eFa9SuseY1IyLl8URJVUlGl7Pij-3EXxS-bDg0FkYBmciWrkxQgo-rCMMmy3qQkRnFtY-JJtQ6NDSRCNjVtxlLA2QerToxqxceDPFberz049JQgS18cFqdGn6EOMG1uYTujHg0WcXgkYXLvxGd8YFZcct-g6jDTv7cWPQ1ZCsg-yZrcBrtAw-h3qY3FitnXnMsYh5bk16XbzowCXz5nAfF6uL89vl5fz625er5eJ6rhjH4xxomVdhSNnVVa3zmjhuVCPB1AQYq7WsZCOJlrrmhDaYcQApKy46rppOm7I8Lj7ufYcYfk0mjW1vkzLOgTdhSq0QomSEcJHJ90_I-zBFn8O1tKxqwStK6kyxPaViSCmarh2i7SFuW4LbXd9t7rt92neWvTuYT7I3-p_ooeAMfDgAkBS4LhetbHrkWMUaLnYpT_dcmIb_-_ovfLHHkg</recordid><startdate>20111001</startdate><enddate>20111001</enddate><creator>Nakae, Ryuta</creator><creator>Yokota, Hiroyuki</creator><creator>Yoshida, Daizo</creator><creator>Teramoto, Akira</creator><general>Oxford University Press</general><general>Lippincott Williams & Wilkins</general><general>Wolters Kluwer Health, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20111001</creationdate><title>Transcranial Doppler Ultrasonography for Diagnosis of Cerebral Vasospasm After Aneurysmal Subarachnoid Hemorrhage: Mean Blood Flow Velocity Ratio of the Ipsilateral and Contralateral Middle Cerebral Arteries</title><author>Nakae, Ryuta ; Yokota, Hiroyuki ; Yoshida, Daizo ; Teramoto, Akira</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c470t-a23647e13f656d148709c9bae61a446db5b9b1dbd67129047aabb578f7c9fde33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Aged</topic><topic>Aneurysms</topic><topic>Biological and medical sciences</topic><topic>Blood Flow Velocity</topic><topic>Cerebrovascular Circulation - physiology</topic><topic>Female</topic><topic>Flow velocity</topic><topic>Functional Laterality - physiology</topic><topic>Humans</topic><topic>Male</topic><topic>Medical diagnosis</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Middle Cerebral Artery - diagnostic imaging</topic><topic>Neurosurgery</topic><topic>Predictive Value of Tests</topic><topic>Retrospective Studies</topic><topic>ROC Curve</topic><topic>Stroke</topic><topic>Subarachnoid Hemorrhage - complications</topic><topic>Subarachnoid Hemorrhage - diagnostic imaging</topic><topic>Subarachnoid Hemorrhage - physiopathology</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography, Doppler, Transcranial</topic><topic>Vasospasm, Intracranial - diagnostic imaging</topic><topic>Vasospasm, Intracranial - etiology</topic><topic>Vasospasm, Intracranial - physiopathology</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nakae, Ryuta</creatorcontrib><creatorcontrib>Yokota, Hiroyuki</creatorcontrib><creatorcontrib>Yoshida, Daizo</creatorcontrib><creatorcontrib>Teramoto, Akira</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nakae, Ryuta</au><au>Yokota, Hiroyuki</au><au>Yoshida, Daizo</au><au>Teramoto, Akira</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transcranial Doppler Ultrasonography for Diagnosis of Cerebral Vasospasm After Aneurysmal Subarachnoid Hemorrhage: Mean Blood Flow Velocity Ratio of the Ipsilateral and Contralateral Middle Cerebral Arteries</atitle><jtitle>Neurosurgery</jtitle><addtitle>Neurosurgery</addtitle><date>2011-10-01</date><risdate>2011</risdate><volume>69</volume><issue>4</issue><spage>876</spage><epage>883</epage><pages>876-883</pages><issn>0148-396X</issn><eissn>1524-4040</eissn><coden>NRSRDY</coden><abstract>Abstract
BACKGROUND:
Transcranial Doppler (TCD) is widely accepted to monitor cerebral vasospasm after subarachnoid hemorrhage (SAH); however, its predictive value remains controversial.
OBJECTIVE:
To investigate the predictive reliability of an increase in the mean blood flow velocity (mBFV) ratio of the ipsilateral to contralateral middle cerebral arteries (I/C mBFV) compared with the conventional absolute flow velocity.
METHODS:
We retrospectively investigated the clinical and radiologic data of consecutive patients with SAH admitted from July 2003 to August 2009 who underwent TCD ultrasonography. The highest mBFV value in bilateral middle cerebral arteries was recorded, while delayed cerebral ischemia (DCI) was defined as neurological deficits or computed tomographic evidence of cerebral infarction caused by vasospasm. The ipsilateral side was defined as the side with higher mBFV value when evaluating the I/C mBFV. We thus elucidated the reliability of this rate in comparison with the conventional method for predicting DCI with receiver operating characteristic (ROC) analysis.
RESULTS:
One hundred and forty-two patients were retrospectively analyzed with specific data from 1262 TCD studies. The ROC curve showed that the overall predictive value for DCI had an area under the curve of 0.86 (95% confidence interval: 0.76-0.96) when the I/C mBFV was used vs 0.80 (0.71-0.88) when the absolute flow velocity was used. The threshold value that best discriminated between patients with and without DCI was I/C mBFV of 1.5.
CONCLUSION:
In patients with SAH, the I/C mBFV demonstrated a more significant correlation to vasospasm than the absolute mean flow velocity.</abstract><cop>Hagerstown, MD</cop><pub>Oxford University Press</pub><pmid>21558976</pmid><doi>10.1227/NEU.0b013e318222dc4c</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0148-396X |
| ispartof | Neurosurgery, 2011-10, Vol.69 (4), p.876-883 |
| issn | 0148-396X 1524-4040 |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Aged Aneurysms Biological and medical sciences Blood Flow Velocity Cerebrovascular Circulation - physiology Female Flow velocity Functional Laterality - physiology Humans Male Medical diagnosis Medical sciences Middle Aged Middle Cerebral Artery - diagnostic imaging Neurosurgery Predictive Value of Tests Retrospective Studies ROC Curve Stroke Subarachnoid Hemorrhage - complications Subarachnoid Hemorrhage - diagnostic imaging Subarachnoid Hemorrhage - physiopathology Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Ultrasonic imaging Ultrasonography, Doppler, Transcranial Vasospasm, Intracranial - diagnostic imaging Vasospasm, Intracranial - etiology Vasospasm, Intracranial - physiopathology Veins & arteries |
| title | Transcranial Doppler Ultrasonography for Diagnosis of Cerebral Vasospasm After Aneurysmal Subarachnoid Hemorrhage: Mean Blood Flow Velocity Ratio of the Ipsilateral and Contralateral Middle Cerebral Arteries |
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