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Power motion-mode Doppler signature: a useful tool for assessing middle cerebral artery stenosis
Ji-Sun Kim1, Sang-Wook Lee, Mi-Yeon Eun
1Department of Neurology, College of Medicine, Korea University, Seoul, Korea.
Purpose:
To identify power motion-mode Doppler (PMD) patterns and assess their diagnostic value for the diagnosis of middle cerebral artery (MCA) stenosis.
Methods:
Retrospective analyses of PMD data were performed for the identification of specific patterns related to MCA stenosis. The interrater reliability and the validity of these patterns were studied, using magnetic resonance angiography and conventional transcranial Doppler sonography as gold standards.
Results:
Three PMD patterns were identified: the so-called black-hole, the white-hole, and the diastolic-band patterns in 58 among 178 MCAs. The mean flow velocity was significantly higher in arterial segments with the black-hole patterns and lower in segments with the diastolic-band pattern compared with the segments with normal patterns. The interrater reliability was good for each pattern. The black-hole pattern or its combination with the white-hole pattern showed the highest validity.
Conclusion:
Despite some limitations, the black-hole PMD pattern or its combination with the white-hole pattern appeared as a reliable and valid marker for the diagnosis of MCA stenosis.
Insights
The black-hole and white-hole power motion-mode Doppler (PMD) patterns show promise for diagnosing middle cerebral artery (MCA) stenosis. These PMD patterns offer a reliable and valid method for identifying MCA stenosis.
Area of Science:
- Neurosonology
- Vascular Neurology
- Medical Imaging
Background:
- Middle cerebral artery (MCA) stenosis is a significant risk factor for stroke.
- Accurate diagnosis of MCA stenosis is crucial for effective treatment and stroke prevention.
Purpose of the Study:
- To identify specific power motion-mode Doppler (PMD) patterns associated with MCA stenosis.
- To evaluate the diagnostic value and reliability of these PMD patterns for MCA stenosis.
Main Methods:
- Retrospective analysis of PMD data from 178 MCAs.
- Identification and characterization of PMD patterns, including black-hole, white-hole, and diastolic-band patterns.
- Assessment of interrater reliability and validity using magnetic resonance angiography and transcranial Doppler sonography as gold standards.
Main Results:
- Three distinct PMD patterns were identified in 58 out of 178 MCAs.
- The black-hole pattern was associated with significantly higher mean flow velocities, while the diastolic-band pattern showed lower velocities.
- The black-hole pattern, alone or combined with the white-hole pattern, demonstrated the highest diagnostic validity with good interrater reliability.
Conclusions:
- The black-hole PMD pattern, particularly when combined with the white-hole pattern, serves as a reliable and valid marker for diagnosing MCA stenosis.
- Despite limitations, these PMD patterns offer a valuable tool in the non-invasive assessment of MCA stenosis.
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