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Updated: May 16, 2026

Point of Care Transcranial Color-Coded Duplex Ultrasound of the Middle Cerebral Artery
Published on: August 9, 2024
Increased pulsatility index is associated with intracranial arterial calcification
Kwang-Yeol Park1, Pil-Wook Chung, Yong Bum Kim
1Department of Neurology, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, South Korea.
Increased intracranial arterial calcification (ICAC) is linked to higher pulsatility index (PI) in the middle cerebral arteries (MCAs). This suggests calcification may increase vascular resistance, impacting blood flow dynamics.
Area of Science:
- Neurology
- Vascular Medicine
- Radiology
Background:
- Pulsatility index (PI) is a measure of distal vascular resistance.
- Intracranial arterial calcification (ICAC) is a common finding in cerebrovascular disease.
Purpose of the Study:
- To investigate the association between intracranial arterial calcification and intracranial pulsatility indices.
- To determine if ICAC is an independent determinant of MCA PI.
Main Methods:
- Transcranial Doppler ultrasonography was used to measure PI in both MCAs.
- Computed tomography angiography assessed ICAC.
- 156 patients with acute ischemic stroke or transient ischemic attack were included, excluding those with carotid steno-occlusion.
Main Results:
- PI showed a significant correlation with ICAC score (r = 0.413, p < 0.001) and age (r = 0.507, p < 0.001).
- Diabetes prevalence increased with higher PI values (p = 0.025).
- Aging and ICAC were independent determinants of MCA PI after adjusting for other factors.
Conclusions:
- Elevated PI is correlated with the severity of ICAC.
- Calcification-related vascular resistance may contribute to increased PI in intracranial arteries.
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