Du Liyong, Hua Yang, Jia Lingyun, Yang Jie, Jiao Liqun, Liu Jiabin
Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, PR China; Beijing Diagnostic Center of Vascular Ultrasound, Beijing, PR China; Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, PR China.
Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, PR China; Beijing Diagnostic Center of Vascular Ultrasound, Beijing, PR China; Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, PR China.
J Clin Neurosci. 2025 Mar;133:111020. doi: 10.1016/j.jocn.2024.111020. Epub 2025 Jan 8.
High variability of intracranial arterial blood flow velocities by Transcranial color-coded sonography (TCCS) has been found in clinical practice. This study aimed to improve diagnostic accuracy by analyzing influencing factors of middle cerebral artery (MCA) blood flow velocity detected by TCCS.
In total, 328 MCA vessels were classified as normal (27.1 %) or having mild (30.2 %), moderate (23.2 %), and severe (19.5 %) stenosis based on computed tomography angiography (CTA). Based on morphology, MCAs were classified as type I (98) or type II (230). Differences in peak systolic velocity (PSV) detected by TCCS and TCD were analyzed at different degrees of MCA stenosis (MCAS), correction angles, and morphology.
The mean rank of MCAS of TCCS was higher than that of TCD and CTA (P < 0.05), with no significant difference between TCD and CTA. The PSV measured by TCCS was significantly higher than that of TCD, but when the correction angle of TCCS was ≤30°, the two PSVs were comparable (P > 0.05). TCCS and TCD measured significantly different PSVs when the TCCS correction angles were >30° in type I and at all correction angles in type II (P < 0.05). The optimal cut-off values for MCAS diagnosis using TCCS increased with increasing correction angles.
The differences in PSVs measured using TCCS and TCD were related to the correction angles and morphology of the MCA. Using optimal cut-off values based on the correction angles allows for more accurate MCAS diagnosis.
经颅彩色编码超声检查（TCCS）发现颅内动脉血流速度存在高度变异性。本研究旨在通过分析TCCS检测大脑中动脉（MCA）血流速度的影响因素来提高诊断准确性。
基于计算机断层血管造影（CTA），共328条MCA血管被分类为正常（27.1%）或存在轻度（30.2%）、中度（23.2%）和重度（19.5%）狭窄。根据形态学，MCA被分为I型（98条）或II型（230条）。分析了在不同程度的MCA狭窄（MCAS）、校正角度和形态下，TCCS和经颅多普勒超声（TCD）检测的收缩期峰值流速（PSV）差异。
TCCS的MCAS平均秩高于TCD和CTA（P<0.05），TCD和CTA之间无显著差异。TCCS测量的PSV显著高于TCD，但当TCCS的校正角度≤30°时，两者的PSV具有可比性（P>0.05）。当TCCS校正角度在I型中>30°以及在II型的所有校正角度时，TCCS和TCD测量的PSV有显著差异（P<0.05）。使用TCCS诊断MCAS的最佳截断值随校正角度增加而升高。
使用TCCS和TCD测量的PSV差异与MCA的校正角度和形态有关。基于校正角度使用最佳截断值可实现更准确的MCAS诊断。
