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An analysis on the diagnostic values of transcranial Doppler and angiography in transient ischemic attack
1Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030.
Insights
Transcranial Doppler (TCD) accurately diagnoses blood vessel stenosis or occlusion in transient ischemic attack (TIA) patients. This non-invasive technique aids in identifying hemodynamic changes, crucial for TIA risk assessment and diagnosis.
Area of Science:
- Neurology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Transient ischemic attack (TIA) is often caused by intracranial or extracranial blood vessel stenosis or occlusion.
- Accurate diagnosis of these vascular abnormalities is critical for TIA management and stroke prevention.
Purpose of the Study:
- To investigate the accuracy and diagnostic value of transcranial Doppler (TCD) in TIA patients.
- To compare TCD findings with digital subtraction angiography (DSA) or magnetic resonance angiography (MRA).
Main Methods:
- Retrospective analysis of 50 TIA patients undergoing routine TCD examinations.
- Comparison of TCD results with DSA or MRA for stenosis and occlusion detection.
- Analysis of hemodynamic changes and flow patterns in affected blood vessels.
Main Results:
- TCD correctly identified stenosis or occlusion in 77% of TIA patients, confirmed by DSA/MRA.
- TCD showed a 78.7% accordance rate with angiography in detecting unilateral stenosis, bilateral stenosis, and siphon segment occlusion.
- Hemodynamic changes in basilar arteries, particularly moderate to severe stenosis or occlusion, were identified as significant TIA risk factors.
Conclusions:
- Transcranial Doppler (TCD) demonstrates significant clinical value in diagnosing TIA.
- TCD is an effective tool for assessing stenosis and occlusion in cerebral arteries, aiding in TIA risk stratification.
Abstract:
The accuracy and diagnostic values of transcranial Doppler (TCD) in transient ischemic attack (TIA) caused by the stenosis or occlusion of intracranial or extracranial blood vessels were investigated. Of the 50 TIA patients receiving routine TCD examinations, 39 cases (77%) were diagnosed as having unilateral or bilateral stenosis or occlusion of MCA, ACA, siphon segment of internal carotid artery, which was furthermore confirmed by digital subtraction angiography (DSA) or MRA, 11 (22%) cases were normal. An analysis on the TCD findings of the flow patterns and hemodynamic changes of the stenotic or occluded blood vessels was made in comparison with that obtained by angiography. It was showed that angiography demonstrated 17 unilateral MCA stenosis, 47 bilateral multi-stenosis, 1 occlusion of the siphon segment of the internal carotid artery, while TCD revealed 17 unilateral stenosis, 64 bilateral stenosis, 1 occlusion respectively, with an accordance rate of 78.7%. It was concluded that the hemodynamic changes secondary to the stenosis of the basalcranial arteries, especially the moderate to severe stenosis or occlusion, might be an important risk factor for TIA. TCD examination achieved significant clinic values in the diagnosing of TIA.