The Application Value Of Transcranial Doppler Ultrasonography In Middle Cerebral Artery Stenosis

Objective:to determine the application value of transcianial Doppler ultrasound(TCD)in diagnosing middle cerebral artery(MCA)stenosis.Methods: the clinical data of patients with isebrovascular disease with simultaneous digital subtract angiography(DSA)and TCD were retrospectively analyzed,and the sensitivity and specificity of TCD in diagnosinchemic cerg MCA stenosis were analyzed with DSA as the gold standard.Meanwhile,the TCD blood flow velocity with normal MCA and different stenosis degrees was compared,and the optimal cut-off value of TCD blood flow velocity with different stenosis degrees of MCA was calculated.Results: DSA confirmed the presence of MCA stenosis or occlusion in 103 patients,including 13 cases of mild stenosis,22 cases of moderate stenosis,40 cases of severe stenosis and 39 cases of occlusion.Compared with DSA,TCD has a sensitivity of 76.8%,specificity of 94%,accuracy of91%,missed diagnosis rate of 20.2% and misdiagnosis rate of 3% in detecting moderate or above MCA stenosis or occlusion.There was no significant difference in blood flow velocity between the mild stenosis group and the normal group;there was no significant difference in blood flow velocity between the moderate stenosis group and the normal group(P<0.05);there was no significant difference in blood flow velocity between the moderate stenosis group and the severe stenosis group.The optimal cut-off value of peak systolic blood flow velocity for moderate stenosis was determined to be 161.5cm/s,and the optimal cut-off value of average blood flow velocity was106.5cm/s.Conclusion: TCD has certain advantages in diagnosing MCA stenosis or occlusion,and can be used as a safe and cheapscreening method before DSA examination.