Detection of intracranial aneurysms with unenhanced and echo contrast enhanced transcranial power Doppler
OBJECTIVE To assess transcranial power Doppler and the effect of an intravenous ultrasonic contrast agent for detecting intracranial aneurysms in patients admitted with a subarachnoid haemorrhage METHODS 203 patients with subarachnoid haemorrhage were examined with the operator blind to the results...
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| Veröffentlicht in: | Journal of neurology, neurosurgery and psychiatry neurosurgery and psychiatry, 2000-04, Vol.68 (4), p.489-495 |
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| creator | Turner, Carole L Kirkpatrick, Peter J |
| description | OBJECTIVE To assess transcranial power Doppler and the effect of an intravenous ultrasonic contrast agent for detecting intracranial aneurysms in patients admitted with a subarachnoid haemorrhage METHODS 203 patients with subarachnoid haemorrhage were examined with the operator blind to the results of the admission CT and subsequent digital subtraction angiogram (DSA). In 98 cases patients were imaged using unenhanced transcranial power Doppler, and in 105 cases, patients were imaged both using unenhanced and echo contrast enhanced (Levovist, Schering AG) transcranial power Doppler. RESULTS DSA detected 168 intracranial aneurysms in 128 patients (24 patients had multiple lesions) and 75 patients had an aneurysm negative DSA. There was agreement between DSA and transcranial power Doppler in 87 intracranial aneurysms of which 20 were only detected after infusion of contrast agent. Without contrast infusion, transcranial power Doppler showed a sensitivity of 40% and specificity of 91%. A significant increase in detection was noted when using a contrast agent (χ2=9.49, p |
| doi_str_mv | 10.1136/jnnp.68.4.489 |
| format | Article |
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In 98 cases patients were imaged using unenhanced transcranial power Doppler, and in 105 cases, patients were imaged both using unenhanced and echo contrast enhanced (Levovist, Schering AG) transcranial power Doppler. RESULTS DSA detected 168 intracranial aneurysms in 128 patients (24 patients had multiple lesions) and 75 patients had an aneurysm negative DSA. There was agreement between DSA and transcranial power Doppler in 87 intracranial aneurysms of which 20 were only detected after infusion of contrast agent. Without contrast infusion, transcranial power Doppler showed a sensitivity of 40% and specificity of 91%. A significant increase in detection was noted when using a contrast agent (χ2=9.49, p<0.001). With a contrast study the sensitivity increased to 55% with a specificity of 83%. Intracranial aneurysm detection by transcranial power Doppler was significantly dependent on position using a contrast infusion (χ2=15.87, p<0.05). A positive correlation was also found between the size of intracranial aneurysms measured by transcranial power Doppler and DSA (r=0.55, p<0.05). The transcranial power Doppler sensitivity and specificity increased with larger aneurysms and reached 100% for intracranial aneurysms greater than 12 mm diameter. Detection by transcranial power Doppler was also dependent on morphology (χ2=14.46, p<0.001). CONCLUSIONS The detection of intracranial aneurysm by transcranial power Doppler is dependent on aneurysm location, size, and morphology and is enhanced with the use of an intravenous contrast agent.</description><identifier>ISSN: 0022-3050</identifier><identifier>EISSN: 1468-330X</identifier><identifier>DOI: 10.1136/jnnp.68.4.489</identifier><identifier>PMID: 10727486</identifier><identifier>CODEN: JNNPAU</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Aneurysms ; Biological and medical sciences ; contrast agent ; Contrast agents ; Contrast Media ; Female ; Humans ; intracranial aneurysm ; Intracranial Aneurysm - diagnostic imaging ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical imaging ; Medical sciences ; Middle Aged ; Morphology ; Mortality ; Nervous system ; R&D ; Research & development ; subarachnoid haemorrhage ; transcranial power Doppler ; Ultrasonic investigative techniques ; Ultrasonography</subject><ispartof>Journal of neurology, neurosurgery and psychiatry, 2000-04, Vol.68 (4), p.489-495</ispartof><rights>Journal of Neurology, Neurosurgery, and Psychiatry</rights><rights>2000 INIST-CNRS</rights><rights>Copyright: 2000 Journal of Neurology, Neurosurgery, and Psychiatry</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b511t-863867c90c2579a66e0a9225c7a09a6e3ede8d98071d0f6e4ba8ad60cda7aa1f3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1736879/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1736879/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1296214$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10727486$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Turner, Carole L</creatorcontrib><creatorcontrib>Kirkpatrick, Peter J</creatorcontrib><title>Detection of intracranial aneurysms with unenhanced and echo contrast enhanced transcranial power Doppler</title><title>Journal of neurology, neurosurgery and psychiatry</title><addtitle>J Neurol Neurosurg Psychiatry</addtitle><description>OBJECTIVE To assess transcranial power Doppler and the effect of an intravenous ultrasonic contrast agent for detecting intracranial aneurysms in patients admitted with a subarachnoid haemorrhage METHODS 203 patients with subarachnoid haemorrhage were examined with the operator blind to the results of the admission CT and subsequent digital subtraction angiogram (DSA). In 98 cases patients were imaged using unenhanced transcranial power Doppler, and in 105 cases, patients were imaged both using unenhanced and echo contrast enhanced (Levovist, Schering AG) transcranial power Doppler. RESULTS DSA detected 168 intracranial aneurysms in 128 patients (24 patients had multiple lesions) and 75 patients had an aneurysm negative DSA. There was agreement between DSA and transcranial power Doppler in 87 intracranial aneurysms of which 20 were only detected after infusion of contrast agent. Without contrast infusion, transcranial power Doppler showed a sensitivity of 40% and specificity of 91%. A significant increase in detection was noted when using a contrast agent (χ2=9.49, p<0.001). With a contrast study the sensitivity increased to 55% with a specificity of 83%. Intracranial aneurysm detection by transcranial power Doppler was significantly dependent on position using a contrast infusion (χ2=15.87, p<0.05). A positive correlation was also found between the size of intracranial aneurysms measured by transcranial power Doppler and DSA (r=0.55, p<0.05). The transcranial power Doppler sensitivity and specificity increased with larger aneurysms and reached 100% for intracranial aneurysms greater than 12 mm diameter. Detection by transcranial power Doppler was also dependent on morphology (χ2=14.46, p<0.001). CONCLUSIONS The detection of intracranial aneurysm by transcranial power Doppler is dependent on aneurysm location, size, and morphology and is enhanced with the use of an intravenous contrast agent.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aneurysms</subject><subject>Biological and medical sciences</subject><subject>contrast agent</subject><subject>Contrast agents</subject><subject>Contrast Media</subject><subject>Female</subject><subject>Humans</subject><subject>intracranial aneurysm</subject><subject>Intracranial Aneurysm - diagnostic imaging</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Morphology</subject><subject>Mortality</subject><subject>Nervous system</subject><subject>R&D</subject><subject>Research & development</subject><subject>subarachnoid haemorrhage</subject><subject>transcranial power Doppler</subject><subject>Ultrasonic investigative techniques</subject><subject>Ultrasonography</subject><issn>0022-3050</issn><issn>1468-330X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqFkc2P1CAYxonRuOPq0ash0RgvHaG0fFxMzOyOmmz04le8EIa-dRhbqNDuuv-9NDPOrl7kQsjz4-HhfRB6TMmSUsZf7rwfllwuq2Ul1R20oBWXBWPk6120IKQsC0ZqcoIepLQj85LqPjqhRJSiknyB3BmMYEcXPA4tdn6Mxkbjnemw8TDF69QnfOXGLZ48-K3xFpqsNBjsNmAb5gtpxEcpH3364zCEK4j4LAxDB_EhuteaLsGjw36KPq3PP67eFhcf3rxbvb4oNjWlYyE5k1xYRWxZC2U4B2JUWdZWGJKPwKAB2ShJBG1Iy6HaGGkaTmxjhDG0Zafo1d53mDY9NBbmiJ0eoutNvNbBOP234t1Wfw-XmgrGpVDZ4PnBIIafE6RR9y5Z6Lo8kDAlLYjiSvIqg0__AXdhij5_LntJWtdUlDxTxZ6yMaQUoT1GoUTPFeq5Qs2lrnSuMPNPbue_Re87y8CzA2CSNV2bh21duuFKxUta3bzr0gi_jrKJPzQXTNT6_eeVlusv6htbEb3O_Is9v-l3_4n4G4Mhw98</recordid><startdate>20000401</startdate><enddate>20000401</enddate><creator>Turner, Carole L</creator><creator>Kirkpatrick, Peter J</creator><general>BMJ Publishing Group Ltd</general><general>BMJ</general><general>BMJ Publishing Group LTD</general><general>BMJ Group</general><scope>BSCLL</scope><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>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20000401</creationdate><title>Detection of intracranial aneurysms with unenhanced and echo contrast enhanced transcranial power Doppler</title><author>Turner, Carole L ; Kirkpatrick, Peter J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b511t-863867c90c2579a66e0a9225c7a09a6e3ede8d98071d0f6e4ba8ad60cda7aa1f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aneurysms</topic><topic>Biological and medical sciences</topic><topic>contrast agent</topic><topic>Contrast agents</topic><topic>Contrast Media</topic><topic>Female</topic><topic>Humans</topic><topic>intracranial aneurysm</topic><topic>Intracranial Aneurysm - diagnostic imaging</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Morphology</topic><topic>Mortality</topic><topic>Nervous system</topic><topic>R&D</topic><topic>Research & development</topic><topic>subarachnoid haemorrhage</topic><topic>transcranial power Doppler</topic><topic>Ultrasonic investigative techniques</topic><topic>Ultrasonography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Turner, Carole L</creatorcontrib><creatorcontrib>Kirkpatrick, Peter J</creatorcontrib><collection>Istex</collection><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>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</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 Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Science Database</collection><collection>Nursing & Allied Health Premium</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>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of neurology, neurosurgery and psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Turner, Carole L</au><au>Kirkpatrick, Peter J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Detection of intracranial aneurysms with unenhanced and echo contrast enhanced transcranial power Doppler</atitle><jtitle>Journal of neurology, neurosurgery and psychiatry</jtitle><addtitle>J Neurol Neurosurg Psychiatry</addtitle><date>2000-04-01</date><risdate>2000</risdate><volume>68</volume><issue>4</issue><spage>489</spage><epage>495</epage><pages>489-495</pages><issn>0022-3050</issn><eissn>1468-330X</eissn><coden>JNNPAU</coden><abstract>OBJECTIVE To assess transcranial power Doppler and the effect of an intravenous ultrasonic contrast agent for detecting intracranial aneurysms in patients admitted with a subarachnoid haemorrhage METHODS 203 patients with subarachnoid haemorrhage were examined with the operator blind to the results of the admission CT and subsequent digital subtraction angiogram (DSA). In 98 cases patients were imaged using unenhanced transcranial power Doppler, and in 105 cases, patients were imaged both using unenhanced and echo contrast enhanced (Levovist, Schering AG) transcranial power Doppler. RESULTS DSA detected 168 intracranial aneurysms in 128 patients (24 patients had multiple lesions) and 75 patients had an aneurysm negative DSA. There was agreement between DSA and transcranial power Doppler in 87 intracranial aneurysms of which 20 were only detected after infusion of contrast agent. Without contrast infusion, transcranial power Doppler showed a sensitivity of 40% and specificity of 91%. A significant increase in detection was noted when using a contrast agent (χ2=9.49, p<0.001). With a contrast study the sensitivity increased to 55% with a specificity of 83%. Intracranial aneurysm detection by transcranial power Doppler was significantly dependent on position using a contrast infusion (χ2=15.87, p<0.05). A positive correlation was also found between the size of intracranial aneurysms measured by transcranial power Doppler and DSA (r=0.55, p<0.05). The transcranial power Doppler sensitivity and specificity increased with larger aneurysms and reached 100% for intracranial aneurysms greater than 12 mm diameter. Detection by transcranial power Doppler was also dependent on morphology (χ2=14.46, p<0.001). CONCLUSIONS The detection of intracranial aneurysm by transcranial power Doppler is dependent on aneurysm location, size, and morphology and is enhanced with the use of an intravenous contrast agent.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd</pub><pmid>10727486</pmid><doi>10.1136/jnnp.68.4.489</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Aneurysms Biological and medical sciences contrast agent Contrast agents Contrast Media Female Humans intracranial aneurysm Intracranial Aneurysm - diagnostic imaging Investigative techniques, diagnostic techniques (general aspects) Male Medical imaging Medical sciences Middle Aged Morphology Mortality Nervous system R&D Research & development subarachnoid haemorrhage transcranial power Doppler Ultrasonic investigative techniques Ultrasonography |
| title | Detection of intracranial aneurysms with unenhanced and echo contrast enhanced transcranial power Doppler |
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