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Accuracy of transcranial colour-coded sonography in the diagnosis of anterior cerebral artery vasospasm
Affiliations- department of neurosurgery
- Department of Invasive Neurology, Medical University of Białystok, Poland
- 1 st Department of Radiology, Medical University of Lublin, ul. Jaczewskiego 8, 20-090 Lublin, Poland
- Kahramanmaras Sutcu Imam University, 46000 Kahramanmaras, Türkiye
- Ankara University Faculty of Medicine, Department of Nuclear Medicine, İbni Sina Hospital, 06410 Ankara, Türkiye
- 1 Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland
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Abstract
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 methodsNinety-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.
ResultsThe 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.
ConclusionsThe 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
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 methodsNinety-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.
ResultsThe 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.
ConclusionsThe 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.
Keywords
cerebral vasospasm, anterior cerebral artery, transcranial colour-coded sonography, ROC curve
About this articleTitle
Accuracy of transcranial colour-coded sonography in the diagnosis of anterior cerebral artery vasospasm
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
233-238
Page views
315
Article views/downloads
512
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
