Transcranial Doppler Correlation with Angiography in Detection of Basilar Artery Stenosis

Yang, Tae-Kyu; Seo, Al-An; Yeo, In-Young; Kim, Hyung-Do; Jung, Woo-Sang; Park, Jung-Mi; Kim, Ok-Jun; Choi, Byung-Ok

The Journal of Internal Korean Medicine > Volume 23(4); 2002 > Article

Original Article

The Journal of Internal Korean Medicine 2002;23(4): 689-694.

허혈성 뇌졸중 환자에서 기저동맥 협착에 대한 TCD 와 Angiography 소견의 비교

양태규, 서알안, 여인영, 김형도, 정우상, 박정미, 김옥준, 최병옥

¹포천중문의과대학교 분당차한방병원 한방내과
²포천중문의과대학교 분당차병원 신경과

Transcranial Doppler Correlation with Angiography in Detection of Basilar Artery Stenosis

Tae-Kyu Yang, Al-An Seo, In-Young Yeo, Hyung-Do Kim, Woo-Sang Jung, Jung-Mi Park, Ok-Jun Kim, Byung-Ok Choi

¹Department of Oriental Internal Medicine, Pundang CHA Oriental Hospital, College of Medicine, Pochon CHA University
²Department of Neurology, Pundang CHA Hospital, College of Medicine, Pochon CHA University

Correspondence

Tae-Kyu Yang ,Tel: 031-780-6287, Email: wind2000@unitel.co.kr

Received: September 13, 2002, Accepted: October 14, 2002, Published online: December 30, 2002.

ABSTRACT

Objectives:
Transcranial doppler(TCD) is a convenient non-invasive screening tool for intracranial stenoses. Several studies regarding the diagnostic value of TCD for detection of middle cerebral artery(MCA) stenosis have been published, Moreover, there have been few studies for basilar artery(BA) stenosis. So we aimed to evaluate the diagnostic accuracy of TCD in detecting BA stenosis among ischemic stroke patients when mean flow velocity(MFV) criteria was applied to them.

Methods :
Fifty-eight ischemic stroke patients(40 men and 18 women, mean age of 61.5) who underwent both cerebral angiography and TCD were observed. TCD was performed a mean of 5 days after angiography and TCD interpretation was performed according to standard criteria.

Results:
When we used MFV cutoff of ≥ 60cm/s in BA as the criteria for stenosis, 4 of 9 stenoses of any degree were detected by TCD with 6 out of 49 false positives. For BA stenosis, TCD had a sensitivity of 44%, specificity of 88%, positive predictive value 40%, negative predictive value 90% in this study.

Conclusions:
TCD may be a less effective screening test for BA stenosis when MFV criteria is used alone. To help avoid false negative results, examination for internal carotid artery(ICA) abnormalities shoud be performed before TCD.

Key words: Intracranial stenosis, transcranial doppler(TCD), basilar artery