Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.
Stroke. 2012 Oct;43(10):2791-3. doi: 10.1161/STROKEAHA.112.665711. Epub 2012 Sep 4.
We explored the association between pulsatility index (PI) as derived from transcranial Doppler ultrasound with various measures of small vessel disease in the community.
We performed transcranial Doppler and magnetic resonance imaging in 205 consecutive community-dwelling elderly subjects who were participants of the Shanghai Aging Study. We investigated the association between middle cerebral artery (MCA) PI with measures of white matter lesions (WML), lacunes, and microbleeds.
Multiple logistic regression found that MCA PI was associated with severe WML (odds ratio, 1.33 per 0.1 increase in PI; 95% confidence interval, 1.04-1.70; P=0.02). At optimal MCA PI cut-off, the area under curve, positive predictive value, and negative predictive value were 0.70 (95% confidence interval, 0.60-0.80), 34.9%, and 85.6%, respectively, for detection of severe WML. No association was found between MCA PI and measures of lacunes or microbleeds.
PI correlates with WML severity. With a high negative predictive value, the chance of having severe WML with a normal PI is low. Transcranial Doppler may guide selective magnetic resonance imaging scanning for the detection of WML in the community.
我们探究了经颅多普勒超声衍生的搏动指数（PI）与社区人群中小血管疾病多种指标之间的相关性。
我们对 205 例连续的社区居住的老年受试者进行了经颅多普勒超声和磁共振成像检查，这些受试者均为上海老龄化研究的参与者。我们调查了大脑中动脉（MCA）PI 与脑白质病变（WML）、腔隙和微出血等指标之间的关系。
多元逻辑回归发现，MCA PI 与严重 WML 相关（优势比，PI 每增加 0.1 时为 1.33；95%置信区间，1.04-1.70；P=0.02）。在最佳 MCA PI 截断值时，曲线下面积、阳性预测值和阴性预测值分别为 0.70（95%置信区间，0.60-0.80）、34.9%和 85.6%，用于检测严重 WML。MCA PI 与腔隙或微出血的指标之间没有相关性。
PI 与 WML 严重程度相关。由于阴性预测值较高，PI 正常的情况下严重 WML 的可能性较低。经颅多普勒可能指导磁共振成像扫描选择性检测社区中的 WML。
