open access

Vol 46, No 3 (2012)
ARTYKUŁ ORYGINALNY
Submitted: 2011-04-15
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Accuracy of transcranial colour-coded sonography in the diagnosis of anterior cerebral artery vasospasm

Grzegorz Turek, Jan Kochanowicz, Robert Rutkowski, Jaroslaw Krejza, Tomasz Lyson, Krzysztof Gorbacz, Justyna Ziełinska-Turek, Zenon Mariak
DOI: 10.5114/ninp.2012.29131
·
Neurol Neurochir Pol 2012;46(3):233-238.

open access

Vol 46, No 3 (2012)
ARTYKUŁ ORYGINALNY
Submitted: 2011-04-15

Abstract

Background and purpose

Transcranial colour-coded sonography (TCCS) has been proven to be a method of high performance in the diagnosis of spasm of the middle cerebral artery (MCA). Relevant data concerning the anterior cerebral artery (ACA) varies amongst studies. The aim of this study was to assess the performance of TCCS in the diagnosis of spasm affecting the ACA.

Material and methods

Ninety-two patients (39 women and 53 men, age 51 ± 12.1 years) were examined using TCCS before cerebral angiography. Of 184 examined ACAs, only 133 arteries could be visualized due to insufficiency of the temporal acoustic window. Therefore, only 15 out of 25 arteries in which vasospasm was diagnosed with angiography (by two neuroradiologists not informed about the sonographic findings) could be included in the analysis. Receiver operating characteristic (ROC) curves were constructed for specific blood flow velocities: peak systolic (PSV), mean (M) and end-diastolic (EDV). The area under the ROC curve was used to measure the overall diagnostic performance of TCCS.

Results

The area under the ROC curve for PSV was 0.83, which indicates good performance. The PSV threshold of 98 cm/s corresponded to maximum accuracy and was associated with 71% sensitivity vs. 88% specificity. Average systolic blood flow velocity in the vessels with vasospasm was 129 cm/s, whereas in unaffected vessels it was 76 cm/s.

Conclusions

The accuracy of TCCS in the diagnosis of ACA spasm is relatively high – the value of the area under the ROC amounts to 0.83. PSV performs best and the threshold of 98 cm/s is associated with an optimal trade-off between sensitivity and specificity.

Abstract

Background and purpose

Transcranial colour-coded sonography (TCCS) has been proven to be a method of high performance in the diagnosis of spasm of the middle cerebral artery (MCA). Relevant data concerning the anterior cerebral artery (ACA) varies amongst studies. The aim of this study was to assess the performance of TCCS in the diagnosis of spasm affecting the ACA.

Material and methods

Ninety-two patients (39 women and 53 men, age 51 ± 12.1 years) were examined using TCCS before cerebral angiography. Of 184 examined ACAs, only 133 arteries could be visualized due to insufficiency of the temporal acoustic window. Therefore, only 15 out of 25 arteries in which vasospasm was diagnosed with angiography (by two neuroradiologists not informed about the sonographic findings) could be included in the analysis. Receiver operating characteristic (ROC) curves were constructed for specific blood flow velocities: peak systolic (PSV), mean (M) and end-diastolic (EDV). The area under the ROC curve was used to measure the overall diagnostic performance of TCCS.

Results

The area under the ROC curve for PSV was 0.83, which indicates good performance. The PSV threshold of 98 cm/s corresponded to maximum accuracy and was associated with 71% sensitivity vs. 88% specificity. Average systolic blood flow velocity in the vessels with vasospasm was 129 cm/s, whereas in unaffected vessels it was 76 cm/s.

Conclusions

The accuracy of TCCS in the diagnosis of ACA spasm is relatively high – the value of the area under the ROC amounts to 0.83. PSV performs best and the threshold of 98 cm/s is associated with an optimal trade-off between sensitivity and specificity.

Get Citation

Keywords

cerebral vasospasm, anterior cerebral artery, transcranial colour-coded sonography, ROC curve

About this article
Title

Accuracy of transcranial colour-coded sonography in the diagnosis of anterior cerebral artery vasospasm

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 46, No 3 (2012)

Pages

233-238

DOI

10.5114/ninp.2012.29131

Bibliographic record

Neurol Neurochir Pol 2012;46(3):233-238.

Keywords

cerebral vasospasm
anterior cerebral artery
transcranial colour-coded sonography
ROC curve

Authors

Grzegorz Turek
Jan Kochanowicz
Robert Rutkowski
Jaroslaw Krejza
Tomasz Lyson
Krzysztof Gorbacz
Justyna Ziełinska-Turek
Zenon Mariak

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