Intracranial vessel localization with power motion Doppler (PMD-TCD) compared with CT angiography in patients with acute ischaemic stroke

Kristian Barlinn, Zeljko Zivanovic, Limin Zhao, Maruthi Kesani, Clotilde Balucani, Georgios Tsivgoulis, Andrei Alexandrov

Research output: Contribution to journalArticle

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Abstract

Introduction: With a view to develop an operator-independent monitoring system for sonothrombolysis, we aimed to evaluate the per cent agreement of power motion transcranial Doppler vessel tracks compared with computed tomography angiography in identification of the anterior and posterior circulation vessels in patients with acute ischaemic stroke. Methods: Consecutive acute ischaemic stroke patients who underwent emergent brain computed tomography angiography and bedside power motion transcranial Doppler were studied. Depth ranges for detecting anterior and posterior circulation vessels were derived from power motion transcranial Doppler flow tracks and computed tomography angiography images of the circle of Willis. We calculated percent agreement of power motion transcranial Doppler with computed tomography angiography for the anterior and posterior circulation vessel localization using computed tomography angiography as reference. Results: Samples were obtained from 34 acute ischaemic stroke patients (mean age 61±16 years, 62% men, median National Institutes of Health Stroke Scale (NIHSS) score 5, interquartile range 2-8). A total of 229 Power motion Doppler computed tomography angiography vessel pairs were analysed. Power motion transcranial Doppler tracks for M1 and proximal M2 middle cerebral artery (MCA) were located at 24-68mm (M1 MCA: 36-68mm; M2 MCA: 24-53mm); anterior cerebral artery (ACA): 50-78mm; P1 posterior cerebral artery (PCA): 50-74mm; left vertebral artery: 30-74mm; right vertebral artery: 30-78mm; basilar artery: 76-106mm. The per cent agreement of power motion Doppler-transcranial Doppler for identifying proximal intracranial arteries compared to computed tomography angiography was: M1 and M2 MCA: 100% (95% confidence interval: 96-100%); M1 MCA: 98% (95% confidence interval: 86-100%); M2 MCA: 94% (95% confidence interval: 79-99%); A1 ACA: 82% (95% confidence interval: 68-91%); P1 PCA: 70% (95% confidence interval: 53-83%); left vertebral artery: 96% (95% confidence interval: 80-100%); right vertebral artery: 96% (95% confidence interval: 79-100%); basilar artery: 100% (95% confidence interval: 89-100%). Conclusions: Power motion transcranial Doppler intercepts proximal vessels with good-to-excellent agreement with computed tomography angiography. Depth ranges (as opposed to average depths) can be used to target intracranial arterial segments for sonothrombolysis.

Original languageEnglish (US)
Pages (from-to)398-402
Number of pages5
JournalInternational Journal of Stroke
Volume8
Issue number6
DOIs
StatePublished - Aug 1 2013

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Middle Cerebral Artery
Stroke
Confidence Intervals
Vertebral Artery
Posterior Cerebral Artery
Anterior Cerebral Artery
Basilar Artery
Circle of Willis
Computed Tomography Angiography
National Institutes of Health (U.S.)
Arteries
Brain

All Science Journal Classification (ASJC) codes

  • Neurology

Cite this

Intracranial vessel localization with power motion Doppler (PMD-TCD) compared with CT angiography in patients with acute ischaemic stroke. / Barlinn, Kristian; Zivanovic, Zeljko; Zhao, Limin; Kesani, Maruthi; Balucani, Clotilde; Tsivgoulis, Georgios; Alexandrov, Andrei.

In: International Journal of Stroke, Vol. 8, No. 6, 01.08.2013, p. 398-402.

Research output: Contribution to journalArticle

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title = "Intracranial vessel localization with power motion Doppler (PMD-TCD) compared with CT angiography in patients with acute ischaemic stroke",
abstract = "Introduction: With a view to develop an operator-independent monitoring system for sonothrombolysis, we aimed to evaluate the per cent agreement of power motion transcranial Doppler vessel tracks compared with computed tomography angiography in identification of the anterior and posterior circulation vessels in patients with acute ischaemic stroke. Methods: Consecutive acute ischaemic stroke patients who underwent emergent brain computed tomography angiography and bedside power motion transcranial Doppler were studied. Depth ranges for detecting anterior and posterior circulation vessels were derived from power motion transcranial Doppler flow tracks and computed tomography angiography images of the circle of Willis. We calculated percent agreement of power motion transcranial Doppler with computed tomography angiography for the anterior and posterior circulation vessel localization using computed tomography angiography as reference. Results: Samples were obtained from 34 acute ischaemic stroke patients (mean age 61±16 years, 62{\%} men, median National Institutes of Health Stroke Scale (NIHSS) score 5, interquartile range 2-8). A total of 229 Power motion Doppler computed tomography angiography vessel pairs were analysed. Power motion transcranial Doppler tracks for M1 and proximal M2 middle cerebral artery (MCA) were located at 24-68mm (M1 MCA: 36-68mm; M2 MCA: 24-53mm); anterior cerebral artery (ACA): 50-78mm; P1 posterior cerebral artery (PCA): 50-74mm; left vertebral artery: 30-74mm; right vertebral artery: 30-78mm; basilar artery: 76-106mm. The per cent agreement of power motion Doppler-transcranial Doppler for identifying proximal intracranial arteries compared to computed tomography angiography was: M1 and M2 MCA: 100{\%} (95{\%} confidence interval: 96-100{\%}); M1 MCA: 98{\%} (95{\%} confidence interval: 86-100{\%}); M2 MCA: 94{\%} (95{\%} confidence interval: 79-99{\%}); A1 ACA: 82{\%} (95{\%} confidence interval: 68-91{\%}); P1 PCA: 70{\%} (95{\%} confidence interval: 53-83{\%}); left vertebral artery: 96{\%} (95{\%} confidence interval: 80-100{\%}); right vertebral artery: 96{\%} (95{\%} confidence interval: 79-100{\%}); basilar artery: 100{\%} (95{\%} confidence interval: 89-100{\%}). Conclusions: Power motion transcranial Doppler intercepts proximal vessels with good-to-excellent agreement with computed tomography angiography. Depth ranges (as opposed to average depths) can be used to target intracranial arterial segments for sonothrombolysis.",
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T1 - Intracranial vessel localization with power motion Doppler (PMD-TCD) compared with CT angiography in patients with acute ischaemic stroke

AU - Barlinn, Kristian

AU - Zivanovic, Zeljko

AU - Zhao, Limin

AU - Kesani, Maruthi

AU - Balucani, Clotilde

AU - Tsivgoulis, Georgios

AU - Alexandrov, Andrei

PY - 2013/8/1

Y1 - 2013/8/1

N2 - Introduction: With a view to develop an operator-independent monitoring system for sonothrombolysis, we aimed to evaluate the per cent agreement of power motion transcranial Doppler vessel tracks compared with computed tomography angiography in identification of the anterior and posterior circulation vessels in patients with acute ischaemic stroke. Methods: Consecutive acute ischaemic stroke patients who underwent emergent brain computed tomography angiography and bedside power motion transcranial Doppler were studied. Depth ranges for detecting anterior and posterior circulation vessels were derived from power motion transcranial Doppler flow tracks and computed tomography angiography images of the circle of Willis. We calculated percent agreement of power motion transcranial Doppler with computed tomography angiography for the anterior and posterior circulation vessel localization using computed tomography angiography as reference. Results: Samples were obtained from 34 acute ischaemic stroke patients (mean age 61±16 years, 62% men, median National Institutes of Health Stroke Scale (NIHSS) score 5, interquartile range 2-8). A total of 229 Power motion Doppler computed tomography angiography vessel pairs were analysed. Power motion transcranial Doppler tracks for M1 and proximal M2 middle cerebral artery (MCA) were located at 24-68mm (M1 MCA: 36-68mm; M2 MCA: 24-53mm); anterior cerebral artery (ACA): 50-78mm; P1 posterior cerebral artery (PCA): 50-74mm; left vertebral artery: 30-74mm; right vertebral artery: 30-78mm; basilar artery: 76-106mm. The per cent agreement of power motion Doppler-transcranial Doppler for identifying proximal intracranial arteries compared to computed tomography angiography was: M1 and M2 MCA: 100% (95% confidence interval: 96-100%); M1 MCA: 98% (95% confidence interval: 86-100%); M2 MCA: 94% (95% confidence interval: 79-99%); A1 ACA: 82% (95% confidence interval: 68-91%); P1 PCA: 70% (95% confidence interval: 53-83%); left vertebral artery: 96% (95% confidence interval: 80-100%); right vertebral artery: 96% (95% confidence interval: 79-100%); basilar artery: 100% (95% confidence interval: 89-100%). Conclusions: Power motion transcranial Doppler intercepts proximal vessels with good-to-excellent agreement with computed tomography angiography. Depth ranges (as opposed to average depths) can be used to target intracranial arterial segments for sonothrombolysis.

AB - Introduction: With a view to develop an operator-independent monitoring system for sonothrombolysis, we aimed to evaluate the per cent agreement of power motion transcranial Doppler vessel tracks compared with computed tomography angiography in identification of the anterior and posterior circulation vessels in patients with acute ischaemic stroke. Methods: Consecutive acute ischaemic stroke patients who underwent emergent brain computed tomography angiography and bedside power motion transcranial Doppler were studied. Depth ranges for detecting anterior and posterior circulation vessels were derived from power motion transcranial Doppler flow tracks and computed tomography angiography images of the circle of Willis. We calculated percent agreement of power motion transcranial Doppler with computed tomography angiography for the anterior and posterior circulation vessel localization using computed tomography angiography as reference. Results: Samples were obtained from 34 acute ischaemic stroke patients (mean age 61±16 years, 62% men, median National Institutes of Health Stroke Scale (NIHSS) score 5, interquartile range 2-8). A total of 229 Power motion Doppler computed tomography angiography vessel pairs were analysed. Power motion transcranial Doppler tracks for M1 and proximal M2 middle cerebral artery (MCA) were located at 24-68mm (M1 MCA: 36-68mm; M2 MCA: 24-53mm); anterior cerebral artery (ACA): 50-78mm; P1 posterior cerebral artery (PCA): 50-74mm; left vertebral artery: 30-74mm; right vertebral artery: 30-78mm; basilar artery: 76-106mm. The per cent agreement of power motion Doppler-transcranial Doppler for identifying proximal intracranial arteries compared to computed tomography angiography was: M1 and M2 MCA: 100% (95% confidence interval: 96-100%); M1 MCA: 98% (95% confidence interval: 86-100%); M2 MCA: 94% (95% confidence interval: 79-99%); A1 ACA: 82% (95% confidence interval: 68-91%); P1 PCA: 70% (95% confidence interval: 53-83%); left vertebral artery: 96% (95% confidence interval: 80-100%); right vertebral artery: 96% (95% confidence interval: 79-100%); basilar artery: 100% (95% confidence interval: 89-100%). Conclusions: Power motion transcranial Doppler intercepts proximal vessels with good-to-excellent agreement with computed tomography angiography. Depth ranges (as opposed to average depths) can be used to target intracranial arterial segments for sonothrombolysis.

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