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Updated: Apr 20, 2026

Point of Care Transcranial Color-Coded Duplex Ultrasound of the Middle Cerebral Artery
Published on: August 9, 2024
Transcranial color flow imaging can evaluate the severity of periventricular hyperintensity
Hidetaka Mitsumura1, Shinji Miyagawa1, Teppei Komatsu1
1Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan.
Background:
The goal of this study was to investigate the relationship between white matter lesions on magnetic resonance imaging and flow parameters in the middle cerebral artery (MCA) measured by transcranial color flow imaging.
Methods:
Patients with acute ischemic stroke or transient ischemic attack were included. The relationship between severities of periventricular hyperintensity (PVH) and ultrasonographic parameters in the MCA was investigated. The frequency of PVH was calculated for different categories according to the presence or absence of 2 considerable parameters according to the value of area under the receiver operating characteristic curve.
Results:
MCA flow was successfully measured in 203 temporal windows among 124 patients. After determining the cutoff value of end-diastolic velocity (EDV) and pulsatility index (PI) for the presence of PVH, 4 different categories were established: Category A, EDV more than 40 cm/second and PI less than .7; Category B, EDV more than 40 cm/second and PI more than .7; Category C, EDV less than 40 cm/second and PI less than .7; and Category D, EDV less than 40 cm/second and PI more than .7. The prevalence of PVH gradually increased along with category (P < .01).
Conclusions:
The evaluation of MCA parameters using the combination of PI and EDV may be useful for the prediction of PVH.
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