Krejza J, Rudzinski W, Pawlak M A, Tomaszewski M, Ichord R, Kwiatkowski J, Gor D, Melhem E R
Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA.
AJNR Am J Neuroradiol. 2007 Sep;28(8):1613-8. doi: 10.3174/ajnr.A0591.
Nonimaging transcranial Doppler sonography (TCD) and imaging TCD (TCDI) are used for determination of the risk of stroke in children with sickle cell disease (SCD). The purpose was to compare angle-corrected, uncorrected TCDI, and TCD blood flow velocities in children with SCD.
A total of 37 children (mean age, 7.8 +/- 3.0 years) without intracranial arterial narrowing determined with MR angiography, were studied with use of TCD and TCDI at the same session. Depth of insonation and TCDI mean velocities with and without correction for the angle of insonation in the terminal internal carotid artery (ICA) and middle (MCA), anterior (ACA), and posterior (PCA) cerebral arteries were compared with TCD velocities with use of a paired t test.
Two arteries were not found on TCDI compared with 15 not found on TCD. Average angle of insonation in the MCA, ACA, ICA, and PCA was 31 degrees , 44 degrees , 25 degrees , and 29 degrees , respectively. TCDI and TCD mean depth of insonation for all arteries did not differ significantly; however, individual differences varied substantially. TCDI velocities were significantly lower than TCD velocities, respectively, for the right and left sides (mean +/- SD): MCA, 106 +/- 22 cm/s and 111 +/- 33 cm/s versus 130 +/- 19 cm/s and 134 +/- 26 cm/s; ICA, 90 +/- 14 cm/s and 98 +/- 27 cm/s versus 117 +/- 18 cm/s and 119 +/- 23 cm/s; ACA, 74 +/- 24 cm/s and 88 +/- 25 cm/s versus 105 +/- 23 cm/s and 105 +/- 31 cm/s; and PCA, 84 +/- 27 cm/s and 82 +/- 21 cm/s versus 95 +/- 23 cm/s and 94 +/- 20 cm/s. TCD and angle-corrected TCDI velocities were not statistically different except for higher angle-corrected TCDI values in the left ACA and right PCA.
TCD velocities are significantly higher than TCDI velocities but are not different from the angle-corrected TCDI velocities. TCDI identifies the major intracranial arteries more effectively than TCD.
非成像经颅多普勒超声（TCD）和成像TCD（TCDI）用于确定镰状细胞病（SCD）患儿的中风风险。目的是比较SCD患儿经角度校正、未经校正的TCDI和TCD血流速度。
共有37名儿童（平均年龄7.8±3.0岁），经磁共振血管造影确定无颅内动脉狭窄，在同一时段接受TCD和TCDI检查。使用配对t检验比较终末颈内动脉（ICA）以及大脑中动脉（MCA）、大脑前动脉（ACA）和大脑后动脉（PCA）的探测深度以及经和未经探测角度校正的TCDI平均速度与TCD速度。
与TCD未发现的15条动脉相比，TCDI未发现2条动脉。MCA、ACA、ICA和PCA的平均探测角度分别为31°、44°、25°和29°。所有动脉的TCDI和TCD平均探测深度无显著差异；然而，个体差异变化很大。TCDI速度分别显著低于右侧和左侧的TCD速度（平均值±标准差）：MCA，106±22 cm/s和111±33 cm/s，而TCD为130±19 cm/s和134±26 cm/s；ICA，90±14 cm/s和98±27 cm/s，而TCD为117±18 cm/s和119±23 cm/s；ACA，74±24 cm/s和88±25 cm/s，而TCD为105±23 cm/s和105±31 cm/s；PCA，84±27 cm/s和82±21 cm/s，而TCD为95±23 cm/s和94±20 cm/s。除左侧ACA和右侧PCA中经角度校正的TCDI值较高外，TCD和经角度校正的TCDI速度无统计学差异。
TCD速度显著高于TCDI速度，但与经角度校正的TCDI速度无差异。TCDI比TCD更有效地识别主要颅内动脉。
