Contrast-enhanced transcranial color-coded duplex sonography criteria for basilar artery stenosis

The aim of this study is to assess contrast-enhanced transcranial color-coded duplex sonography (CE-TCCS) diagnosis of basilar artery (BA) stenosis.

CE-TCCS and cerebral angiography were performed in 120 consecutive patients. The patients were angiographically divided into five groups: (1) intracranial arteries (ICA) stenosis but no BA stenosis as intracranial stenosis (ICS) group, (2) both ICA and BA stenoses as internal carotid arteay and basilar arteay stenoses (IBS) group, (3) BA stenosis as basilar artery stenosis (BAS) group, (4) BA occlusion as basilar artery occlusion (BAO) group, and (5) no arterial lesions as Control group. We compared the peak systolic flow velocity (PSV) of BA using CE-TCCS.

PSV was highest in the BAS group (n= 9, 206.1 +/- 118.6 cm/sec), followed by the ICS (n= 27, 74.9 +/- 36.1 cm/sec) and Control (n= 70, 58.2 +/- 17.3 cm/sec) groups. IBS group had two patients (PSV: 102 cm/sec and 167 cm/sec). Sensitivity-specificity curve analysis revealed a cutoff PSV of 120 cm/sec to distinguish the BAS group from other groups, and then we calculated sensitivity of 100%, specificity of 95%, positive predictive value of 64%, negative predictive value of 100%, and accuracy of 95%.

Measurement of PSV of the BA using CE-TCCS is useful for the identification of BA stenosis.