The Role Of TCD In Evaluation Of Vertebra-Basilar Arterial Transient Ischemic Attack

Objective To analyze the value of transcranial Doppler ultrasonography(TCD)in evaluation of blood vessel of patients with transient ischemic attack(TIA)on vertebra-basilar system and the correlation between cerebrovascular risk factors and vertebra-basilar stenosis.Method 52 patients with recurrent vertebra-basilar system TIA who were performed with TCD,CTA and DSA were included in this experiment.The results of the three tests were compared with each other using Kappa coefficient consistency.Logistic correlation analysis of risk factors was performed according to DSA results.All data were analyzed using SPSS 20 statistical software.Results 1.Micro-embolic signal was detected in 4 patients among the 52 patients via TCD.Meanwhile one of the 4 patients was diagnosed PFO via TCD.2.Comparison of consistency between TCD,CTA and DSA test:(a)Comparison of consistency between TCD and CTA: The Kappa coefficient of left vertebral artery,right vertebral artery and Basal artery was 0.957,0.877 and 0.770 respectively.The total Kappa coefficient of the three vessels was 0.884.(b)Comparison of consistency between TCD and DSA:The Kappa coefficient of left vertebral artery,right vertebral artery and Basal artery was 0.913,0.796 and 0.867 respectively.The total Kappa coefficient of the three vessels was 0.871.(c)Comparison of consistency between CTA and DSA: the Kappa coefficient of left vertebral artery,right vertebral artery and Basal artery were 0.962,and 0.878 and 0.831 respectively.The Total Kappa coefficient of the three vessels was 0.891.3.Analysis of the relationship between risk factors andvertebra-basilar stenosis: a)the risk of basal artery stenosis was higher in patients with the history of hypertension and smoking(OR: 64.408,4.726 respectively)than those non-hypertension and non-smoking.b)There was no significant correlation between vertebral artery stenosis and the factors including gender,age,frequencyof attack,hypertension,diabetes,coronary heart disease,hyperlipidemia,smoking and drinking.Conclusion 1.TCD can be used as a tool to screen micro-embolism and PFO in the vertebral-basilar artery TIA and a guidance of clinical treatment.2.TCD has good consistency with CTA or DSA in the results of the detection of vertebral basilar artery stenosis.3.The basilar artery stenosis was significantly correlated with hypertension and smoking.There was no significant correlation between vertebral artery stenosis and cerebrovascular disease risk factors.