The Journal of the Society of Stroke on Korean Medicine (대한중풍순환신경학회지)

The Society of Stroke on Korean Medicine (대한중풍순환신경학회)
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The Diagnostic Accordance between Transcranial Doppler and MR Angiography in the Intracranial Artery Stenosis

두개강내 혈관 협착에 대한 경두개도플러와 자기공명 혈관조영술의 일치도 평가

  • Moon, Sang-kwan (Department of Cardiovascular and Neurologic Diseases (Stroke Center), College of Oriental Medicine, Kyung Hee University) ;
  • Jung, Woo-sang (Department of Cardiovascular and Neurologic Diseases (Stroke Center), College of Oriental Medicine, Kyung Hee University) ;
  • Park, Sung-uk (Department of Cardiovascular and Neurologic Diseases (Stroke Center), College of Oriental Medicine, Kyung Hee University) ;
  • Park, Jung-mee (Department of Cardiovascular and Neurologic Diseases (Stroke Center), College of Oriental Medicine, Kyung Hee University) ;
  • Ko, Chang-nam (Department of Cardiovascular and Neurologic Diseases (Stroke Center), College of Oriental Medicine, Kyung Hee University) ;
  • Cho, Ki-ho (Department of Cardiovascular and Neurologic Diseases (Stroke Center), College of Oriental Medicine, Kyung Hee University) ;
  • Bae, Hyung-sup (Department of Cardiovascular and Neurologic Diseases (Stroke Center), College of Oriental Medicine, Kyung Hee University) ;
  • Kim, Young-suk (Department of Cardiovascular and Neurologic Diseases (Stroke Center), College of Oriental Medicine, Kyung Hee University) ;
  • Cho, Seong-il (Department of Epidemiology, Graduate School of Public Health, Seoul National University)
  • 문상관 (경희대학교 한의과대학 제2내과학교실) ;
  • 정우상 (경희대학교 한의과대학 제2내과학교실) ;
  • 박성욱 (경희대학교 한의과대학 제2내과학교실) ;
  • 박정미 (경희대학교 한의과대학 제2내과학교실) ;
  • 고창남 (경희대학교 한의과대학 제2내과학교실) ;
  • 조기호 (경희대학교 한의과대학 제2내과학교실) ;
  • 배형섭 (경희대학교 한의과대학 제2내과학교실) ;
  • 김영석 (경희대학교 한의과대학 제2내과학교실) ;
  • 조성일 (서울대학교 보건대학원 역학교실)
  • Published : 2006.12.01
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Abstract

Objectives : Transcranial Doppler (TCD) has been reported to be established as useful in detecting spasm after subarachnoid hemorrhage and to be probably useful in diagnosing stenosis or occlusion in intracranial arteries. In the detection of intracranial stenosis using TCD there have been reported some kinds of diagnostic criteria. This study was aimed to evaluate the accordance between TCD and magnetic resonance angiography (MRA) in detection of intracranial stenosis and to find out more accurate criteria for intracranial stenosis using TCD. Methods : Seventy-six stroke patients were evaluated by TCD and MRA. TCD criteria for middle cerebral artery (MCA) stenosis were used by 3 methods; ≥ 80cm/sec of mean velocity(Vm), ≥ 140 cm/sec of systolic velocity(Vs), and both. For stenosis of vertebral(VA) and basilar arteries(BA), the TCD criteria followed by 2 methods; ≥ 70 cm/sec of Vm and ≥ 100 cm/sec of Vs. The stenosis of intracranial artery in MRA followed by the interpretation of specialist in the department of radiology. The sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy and kappa agreement were calculated in each criteria of TCD compared with the result of MRA. Results : The sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy and kappa agreement using ≥ 80cm/sec of Vm for MCA stenosis were 55.6%, 81%, 34.5%, 91.0%, 77.1%, and 0.293, respectively. Using 140 cm/sec of Vs, those were 44.4%, 92.0%, 50.5%, 90.2%, 84.7%, 0.380, and using both criteria those were 44.4%, 95.0%, 61.5%, 90.5%, 87.3%, 0.445, respectively. Those using ≥ 70 cm/sec of Vm for VA and BA stenosis were 71.4%, 93.7%, 26.3%, 99.0%, 93.0%, 0.186 and using ≥ 100 cm/sec of Vs those were 71.4%, 97.3%, 45.5%, 99.1%, 96.5%, 0.539, respectively. Conclusion : These results suggested that for the diagnosis of MCA stenosis using TCD we should use the criteria of both ≥ 80cm/sec of Vm and 140 cm/sec of Vs, and for the VA and BA stenosis we adapt the criteria of ≥ 70 cm/sec of Vm.

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