Evaluation of Contrast-enhanced Transcranial Color-coded Duplex Sonography (CE-TCCD) Applied in Stroke Patients with Intracranial Collateral Circulation

2020 ◽  
Vol 16 (7) ◽  
pp. 887-891
Author(s):  
Jin Xing ◽  
Bin Xu ◽  
Lin Zhai ◽  
Yan Men ◽  
Dan Zhang ◽  
...  
Keyword(s):  
Collateral Circulation ◽  
Duplex Sonography ◽  
Arterial Blood Flow ◽  
Anterior Communicating Artery ◽  
Stroke Patients ◽  
Diagnostic Efficacy ◽  
Arterial Blood ◽  
Contrast Enhanced ◽  
Temporal Bones ◽  
Color Coded Duplex Sonography

Background and Introduction: Collateral circulation is very crucial for the prognosis of stroke patients. Transcranial color-coded duplexsonography (TCCD) is used widely to evaluate the intracranial arterial blood flow. However, approximately 20% - 30% of the patients with cerebral infarction cannot be detected via TCCD due to the interruption of thickened temporal bones. We assessed the diagnostic efficacy of contrast-enhanced transcranial color-coded duplexsonography (CE-TCCD) in stroke patients with limited bone windows. Methods: CE-TCCD was applied to 70 patients (51 males and 19 females) who presented with ischemic symptoms, to detect the openness of the anterior communicating artery (ACoA) and posterior communicating artery (PCoA) of the Willis ring before Computed Tomography angiography (CTA) or Magnetic Resonance Angiography (MRA) examination. The results from CETCCD is used to compare with CTA/MRA result to verify the diagnostic efficacy. Results: Forty-one communicating artery openings were detected by CE-TCCD, among which 37 were PCoA and 4 were ACoA. Among the 70 patients, 23 of 70 patients indicated severe stenosis within intracranial and/or extracranial arteries. Eighteen out of the 23 patients showed collateral circulation, accounting for 78.3% (18/23). Moderate stenosis were 23 cases in total, in which 7 cases showed collateral circulation, accounting for 30.4% (7/23). Slight stenosis were 24 cases in total, none of which showed collateral circulation. Conclusion : In the stroke patients with limited bone windows, CE-TCCD can evaluate intracranial collateral circulation.

scholarly journals Transcranial Color Coded Duplex Sonography Findings in Stroke Patients Undergoing Rehabilitation: An Observational Study

2022 ◽  
Author(s):  
Srikant Venkatakrishnan ◽  
Meeka Khanna ◽  
Anupam Gupta
Keyword(s):  
Clinical Outcome ◽  
Duplex Sonography ◽  
Modified Rankin Scale ◽  
Mean Flow ◽  
Stroke Patients ◽  
Symmetric Flow ◽  
Rehabilitation Outcomes ◽  
Outcome Scores ◽  
Color Coded Duplex Sonography ◽  
Flow Velocities

Abstract Background Transcranial color-coded duplex sonography (TCCD) provides information on intracranial blood flow status in stroke patients and can predict rehabilitation outcomes. Objective This study aimed to assess middle cerebral artery (MCA) parameters using TCCD in MCA territory stroke patients admitted for rehabilitation and correlate with clinical outcome measures. Material and Methods Patients aged 18 to 65 years with a first MCA territory stroke, within 6 months of onset were recruited. The clinical outcome scales and TCCD parameters were assessed at both admission and discharge. The scales used were the Scandinavian stroke scale (SSS), Barthel Index (BI), modified Rankin Scale (mRS), Fugl–Meyer upper extremity scale (FMA-UE), modified motor assessment scale (mMAS) scores. TCCD parameters measured were MCA peak systolic, end diastolic, mean flow velocities (MFV), and index of symmetry (SI) and were correlated with clinical scores. Results Fourteen patients were recruited with median age of 56.5 years, median duration of stroke was 42.5 days. Mean flow velocities of affected and unaffected MCA were 46.2 and 50.7 cm/s, respectively. Flow velocities and SI did not change between the two assessments. There was significant improvement in clinical outcome scores at discharge. Significant correlation was observed for patient group with SI > 0.9 at admission with FMA-UE, SSS, and BI scores at discharge (p < 0.05). Conclusion Flow velocity parameters did not change during in-patient rehabilitation. Patients with symmetric flow at admission had improved clinical outcomes measure scores at discharge. Thus SI can predict rehabilitation outcomes in stroke survivors.

Effects of sildenafil on major arterial blood flow using duplex sonography

2005 ◽  
Vol 33 (4) ◽  
pp. 173-175 ◽  
Author(s):  
Ercan Kocakoc ◽  
Arslan Ardicoglu ◽  
Zulkif Bozgeyik ◽  
Adem Kiris ◽  
Veysel Yuzgec ◽  
...  
Keyword(s):  
Blood Flow ◽  
Duplex Sonography ◽  
Arterial Blood Flow ◽  
Arterial Blood

Contrast-Enhanced Transcranial Color-Coded Duplex Sonography Criteria for Basilar Artery Stenosis

2008 ◽  
Vol 18 (4) ◽  
pp. 407-410 ◽  
Author(s):  
Yohei Tateishi ◽  
Yasuyuki Iguchi ◽  
Kazumi Kimura ◽  
Takeshi Inoue ◽  
Kensaku Shibazaki ◽  
...  
Keyword(s):  
Basilar Artery ◽  
Duplex Sonography ◽  
Artery Stenosis ◽  
Contrast Enhanced ◽  
Basilar Artery Stenosis ◽  
Color Coded Duplex Sonography

scholarly journals Comparison of brain vessel imaging from transtemporal and transcondylar approaches using contrast-enhanced transcranial color-coded duplex sonography and Virtual Navigator

2015 ◽  
Vol 159 (4) ◽  
pp. 595-600 ◽  
Author(s):  
David Skoloudik ◽  
Martin Kuliha ◽  
Martin Roubec ◽  
Jaroslav Havelka ◽  
Katerina Langova ◽  
...  
Keyword(s):  
Duplex Sonography ◽  
Vessel Imaging ◽  
Contrast Enhanced ◽  
Color Coded Duplex Sonography ◽  
Brain Vessel

Abstract TP63: Detection of Perfusion Deficits Using FLAIR and GRE Based Vessel Signs

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Dennys Reyes ◽  
Emi Hitomi ◽  
Alexis Simpkins ◽  
John Lynch ◽  
Amie Hsia ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Roc Analysis ◽  
Area Under The Curve ◽  
Arterial Blood Flow ◽  
Lesion Volume ◽  
Perfusion Deficit ◽  
Stroke Patients ◽  
Time To Peak ◽  
Arterial Blood ◽  
Perfusion Deficits

Background: The presence of a perfusion deficit in an acute stroke patient can play an important role in their clinical management. However, many patients are unable to have perfusion-weighted imaging (PWI) due to renal disease. Perfusion deficits are often accompanied by FLAIR hyperintense vessels (FHV), presumably due to slow arterial blood flow, and GRE hypointense vessels (GHV), presumably due to venous congestion. Purpose: To determine how well FHV and GHV perform at identifying PWI lesions. Methods: One rater, blinded to the PWI MR sequences, retrospectively reviewed the DWI, FLAIR and GRE scans of acute stroke patients enrolled in the NIH Natural History of Stroke study during 2013-2014 who had an MRI with PWI prior to being treated with IV tPA. DWI images were used to guide evaluation of the FLAIR and GRE images for FHV and GHV and in each case were classified as definitively present, possibly present or absent. PWI lesion volumes were calculated by thresholding the time-to-peak (TTP) maps at 4 seconds beyond normal tissue. ROC analysis was used to assess the performance of FHV and GHV at various PWI lesion volume thresholds. Results: 102 patients were included in the analysis; their mean PWI lesion volume was 52 mL with a standard deviation of +/- 66 mL. 22% of patients had no perfusion deficit. The ROC analysis found the presence of any FHV performed the best with an area under the curve (AUC) of 0.925 displayed in the figure. Any GHV performed modestly with an AUC of 0.776. Combining FHV with GHV did not improve the performance over FHV alone (AUC=0.876). The sensitivity and specificity for identifying any perfusion deficit with FHV was 95% and 67% respectively with 87% being correctly classified. For detecting a PWI lesion greater than 10 mL, FHV had an 80% sensitivity and 93% specificity classifying 83% correctly. Conclusions: FHV is highly sensitive for identifying a perfusion deficit in stroke patients, and for patients with a lesion volume greater than 10 mL it is highly specific.

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