2004 issue 3

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Volume 13, issue 3

Clinical observations

Diagnostic accuracy of the transcranial Doppler ultrasound in casus of the middle cerebral artery vasospasm

JAN KOCHANOWICZ1, JAROSŁAW KREJZA2,3, ANDRZEJ LEWSZUK2, KAZIMIERZ KORDECKI2, JANUSZ LEWKO1, ZENON MARIAK1
1. Kliniki Neurochirurgii Akademii Medycznej w Białymstoku
2. Zakładu Radiologii Akademii Medycznej w Białymstoku
3. Division of Neuroradiology, University of Pennsylvania, Philadelphia, USA
Postępy Psychiatrii i Neurologii, 2004, 13 (3), 277-282
Keywords: transcranial color Doppler ultrasound, cerebral vasospasm, subarachnoid hemorrhage

Abstract

Objectives. The transcranial Doppler ultrasound development for use in the diagnosis of the middle cerebral artery vasospasm in patients with subarachnoid hemorrhage is described.

Review. Limitations of a conventional ultrasound, the precursor of the transcranial color Doppler ultrasound used for estimation of blood flow velocity are discussed. Transcranial Doppler ultrasound (TUD) accuracy is evaluated by analysis of the receiver-operating characteristic (ROC). The velocity threshold for recognition of the middle cerebral artery vasospasm is also established. Standardization taking into account patients' age and gender, as well as the Lindegaard score (VMCA/VICA) make the method more precise, especially in the diagnosis of small intensity vasospasms.

Conclusion. The results show that newer methods of transcranial Doppler ultrasound, using colour blood flow estimation are becoming an essential tool in the hands of the neuroradiologist.

Address for correspondence:
Dr Jan Kochanowicz,
Klinika Neurochirurgii Akademii Medycznej, ul. M. Curie-Skłodowskiej 24a,
15-276 Białystok,
e-mail: janekl3@op.pl