Evaluation the accuracy of diagnostic criteria of basilar artery stenosis by transcranial Doppler combined with transcranial color code sonography

Abstract

Objective To investigate the accuracy of hemodynamic parameters of diagnostic criteria for basilar artery stenosis by transcranial Doppler (TCD) combined with transcranial color code sonography (TCCS). Methods 261 cases with basilar artery stenosis detected by TCD or TCCS and confirmed by DSA were included in this study. The velocity of peak systolic (PSVBA), end diastolic (EDVBA), mean velocity (MFVBA), the depth (D) at the stenosis, the highest PSV of bilateral posterior cerebral arteries (PSVPCA) and intracranial segment of vertebral artery (PSVVA) were detected and recorded respectively. Depending on the findings of DSA, the receiver operating characteristic curve (ROC) was used to evaluated the sensitivity, specificity and accuracy for the PSVBA, EDVBA, MFVBA, PSVBA/PSVVA and PSVBA/PSVPCA. Results The depth of proximal, middle and distal segment of basilar artery stenosis were detected at (90±5.4) mm, (97+3.0) mm, and (104+4.2) mm respectively. The best parameter of diagnostic criteria for the mild、middle and severe basilar artery stenosis were 110 cm/s≤PSVBA≤150 cm/s or 65 cm/s≤MFVBA≤90 cm/s, 150 cm/s≤PSVBA≤210 cm/s or 90 cm/s≤MFVBA≤135 cm/s and PSVBA≥210 cm/s or PSVBA/PSVVA≥3.5. Conclusion The combination of TCD and TCCS, and choosing the hemodynamic parameters of PSV, MFV and PSVBA/PSVVA , can better assess the basilar artery stenosis, especially for severe basilar artery stenosis. Key words: Ultrasonography, Doppler, transcranial; Vertebrobasilar insufficiency; Basilar artery