A spectrum of knock-type doppler signals in the intracranial vessels

Georgios Tsivgoulis, Bing L. Man, Annabelle Y. Lao, Vijay K. Sharma, Vassilios Kotsis, Konstantinos Vadikolias, Andrei Alexandrov

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background and Purpose-Knock-type Doppler signals (KTDS) are detectable by transcranial Doppler, and it has been hypothesized that they are related to an occlusion of a small perforating artery and microvascular ischemia. However, the nature of KTDS has not been prospectively defined. We aimed at describing the spectral and power motion Doppler characteristics of KTDS and ultrasound exposure conditions that lead to their appearance. Methods-Consecutive patients referred with symptoms of stroke or transient ischemic attacks to our cerebrovascular ultrasound laboratory were screened for the presence of KTDS. The presence of microvascular ischemia was assessed using brain MRI. Results-Among 327 patients with cerebrovascular symptoms, 46 (14%) had KTDS. KTDS were found more frequently in posterior circulation vessels (55% vertebral artery, 21.5% basilar artery, and 6% posterior cerebral artery). There was no association between ultrasound identification of KTDS and the presence of brain ischemia in the distribution of any vessel (OR, 0.37;95% CI, 0.09-1.53;P=0.171) on univariate logistic regression analyses. KTDS was not related to the presence of microvascular ischemia on brain MRI (OR, 1.12;95% CI, 0.55-2.29;P=0.761). We described the range of spectral and power motion Doppler appearances of KTDS and experimentally demonstrated the most likely underlying mechanism being a large vessel wall movement artifact. Conclusions-Although KTDS can be distinguished from other spectral flow signals, they can be found in normal vessels, they do not seem to be associated with the vessel affected by ischemia, and they should not be overinterpreted.

Original languageEnglish (US)
Pages (from-to)644-647
Number of pages4
JournalStroke
Volume40
Issue number2
DOIs
StatePublished - Feb 1 2009

Fingerprint

Ischemia
Brain Ischemia
Posterior Cerebral Artery
Doppler Ultrasonography
Basilar Artery
Vertebral Artery
Transient Ischemic Attack
Artifacts
Arteries
Logistic Models
Stroke
Regression Analysis
Brain

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Cite this

A spectrum of knock-type doppler signals in the intracranial vessels. / Tsivgoulis, Georgios; Man, Bing L.; Lao, Annabelle Y.; Sharma, Vijay K.; Kotsis, Vassilios; Vadikolias, Konstantinos; Alexandrov, Andrei.

In: Stroke, Vol. 40, No. 2, 01.02.2009, p. 644-647.

Research output: Contribution to journalArticle

Tsivgoulis, G, Man, BL, Lao, AY, Sharma, VK, Kotsis, V, Vadikolias, K & Alexandrov, A 2009, 'A spectrum of knock-type doppler signals in the intracranial vessels', Stroke, vol. 40, no. 2, pp. 644-647. https://doi.org/10.1161/STROKEAHA.108.517797
Tsivgoulis G, Man BL, Lao AY, Sharma VK, Kotsis V, Vadikolias K et al. A spectrum of knock-type doppler signals in the intracranial vessels. Stroke. 2009 Feb 1;40(2):644-647. https://doi.org/10.1161/STROKEAHA.108.517797
Tsivgoulis, Georgios ; Man, Bing L. ; Lao, Annabelle Y. ; Sharma, Vijay K. ; Kotsis, Vassilios ; Vadikolias, Konstantinos ; Alexandrov, Andrei. / A spectrum of knock-type doppler signals in the intracranial vessels. In: Stroke. 2009 ; Vol. 40, No. 2. pp. 644-647.
@article{03a8c3c8f8a3437da9b9c239da2e6e53,
title = "A spectrum of knock-type doppler signals in the intracranial vessels",
abstract = "Background and Purpose-Knock-type Doppler signals (KTDS) are detectable by transcranial Doppler, and it has been hypothesized that they are related to an occlusion of a small perforating artery and microvascular ischemia. However, the nature of KTDS has not been prospectively defined. We aimed at describing the spectral and power motion Doppler characteristics of KTDS and ultrasound exposure conditions that lead to their appearance. Methods-Consecutive patients referred with symptoms of stroke or transient ischemic attacks to our cerebrovascular ultrasound laboratory were screened for the presence of KTDS. The presence of microvascular ischemia was assessed using brain MRI. Results-Among 327 patients with cerebrovascular symptoms, 46 (14{\%}) had KTDS. KTDS were found more frequently in posterior circulation vessels (55{\%} vertebral artery, 21.5{\%} basilar artery, and 6{\%} posterior cerebral artery). There was no association between ultrasound identification of KTDS and the presence of brain ischemia in the distribution of any vessel (OR, 0.37;95{\%} CI, 0.09-1.53;P=0.171) on univariate logistic regression analyses. KTDS was not related to the presence of microvascular ischemia on brain MRI (OR, 1.12;95{\%} CI, 0.55-2.29;P=0.761). We described the range of spectral and power motion Doppler appearances of KTDS and experimentally demonstrated the most likely underlying mechanism being a large vessel wall movement artifact. Conclusions-Although KTDS can be distinguished from other spectral flow signals, they can be found in normal vessels, they do not seem to be associated with the vessel affected by ischemia, and they should not be overinterpreted.",
author = "Georgios Tsivgoulis and Man, {Bing L.} and Lao, {Annabelle Y.} and Sharma, {Vijay K.} and Vassilios Kotsis and Konstantinos Vadikolias and Andrei Alexandrov",
year = "2009",
month = "2",
day = "1",
doi = "10.1161/STROKEAHA.108.517797",
language = "English (US)",
volume = "40",
pages = "644--647",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - A spectrum of knock-type doppler signals in the intracranial vessels

AU - Tsivgoulis, Georgios

AU - Man, Bing L.

AU - Lao, Annabelle Y.

AU - Sharma, Vijay K.

AU - Kotsis, Vassilios

AU - Vadikolias, Konstantinos

AU - Alexandrov, Andrei

PY - 2009/2/1

Y1 - 2009/2/1

N2 - Background and Purpose-Knock-type Doppler signals (KTDS) are detectable by transcranial Doppler, and it has been hypothesized that they are related to an occlusion of a small perforating artery and microvascular ischemia. However, the nature of KTDS has not been prospectively defined. We aimed at describing the spectral and power motion Doppler characteristics of KTDS and ultrasound exposure conditions that lead to their appearance. Methods-Consecutive patients referred with symptoms of stroke or transient ischemic attacks to our cerebrovascular ultrasound laboratory were screened for the presence of KTDS. The presence of microvascular ischemia was assessed using brain MRI. Results-Among 327 patients with cerebrovascular symptoms, 46 (14%) had KTDS. KTDS were found more frequently in posterior circulation vessels (55% vertebral artery, 21.5% basilar artery, and 6% posterior cerebral artery). There was no association between ultrasound identification of KTDS and the presence of brain ischemia in the distribution of any vessel (OR, 0.37;95% CI, 0.09-1.53;P=0.171) on univariate logistic regression analyses. KTDS was not related to the presence of microvascular ischemia on brain MRI (OR, 1.12;95% CI, 0.55-2.29;P=0.761). We described the range of spectral and power motion Doppler appearances of KTDS and experimentally demonstrated the most likely underlying mechanism being a large vessel wall movement artifact. Conclusions-Although KTDS can be distinguished from other spectral flow signals, they can be found in normal vessels, they do not seem to be associated with the vessel affected by ischemia, and they should not be overinterpreted.

AB - Background and Purpose-Knock-type Doppler signals (KTDS) are detectable by transcranial Doppler, and it has been hypothesized that they are related to an occlusion of a small perforating artery and microvascular ischemia. However, the nature of KTDS has not been prospectively defined. We aimed at describing the spectral and power motion Doppler characteristics of KTDS and ultrasound exposure conditions that lead to their appearance. Methods-Consecutive patients referred with symptoms of stroke or transient ischemic attacks to our cerebrovascular ultrasound laboratory were screened for the presence of KTDS. The presence of microvascular ischemia was assessed using brain MRI. Results-Among 327 patients with cerebrovascular symptoms, 46 (14%) had KTDS. KTDS were found more frequently in posterior circulation vessels (55% vertebral artery, 21.5% basilar artery, and 6% posterior cerebral artery). There was no association between ultrasound identification of KTDS and the presence of brain ischemia in the distribution of any vessel (OR, 0.37;95% CI, 0.09-1.53;P=0.171) on univariate logistic regression analyses. KTDS was not related to the presence of microvascular ischemia on brain MRI (OR, 1.12;95% CI, 0.55-2.29;P=0.761). We described the range of spectral and power motion Doppler appearances of KTDS and experimentally demonstrated the most likely underlying mechanism being a large vessel wall movement artifact. Conclusions-Although KTDS can be distinguished from other spectral flow signals, they can be found in normal vessels, they do not seem to be associated with the vessel affected by ischemia, and they should not be overinterpreted.

UR - http://www.scopus.com/inward/record.url?scp=60549083071&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=60549083071&partnerID=8YFLogxK

U2 - 10.1161/STROKEAHA.108.517797

DO - 10.1161/STROKEAHA.108.517797

M3 - Article

VL - 40

SP - 644

EP - 647

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 2

ER -