The Assessment of Diagnostic Accuracy for Basilar Artery Stenosis by Transcranial Color-Coded Sonography

This study aimed to determine the optimal criteria for evaluating basilar artery stenosis (BAS) by transcranial color-coded sonography (TCCS). A total of 403 cases with both TCCS and digital subtraction angiography (DSA) were enrolled. Peak systolic velocity (PSV), end diastolic velocity (EDV) and mean flow velocity (MFV) of the basilar artery (BA), intracranial vertebral artery (IVA) and posterior cerebral artery (PCA) were measured. The ratios PSV_BA/PSV_IVA and PSV_BA/PSV_PCA were calculated. With DSA as the reference, the optimal criteria for grading BAS were determined by receiver operating characteristic analysis. They were as follows: PSV ≥110 cm/s, MFV ≥70 cm/s and PSV_BA/PSV_IVA ≥1.5 for <50% BAS; PSV ≥150 cm/s, MFV ≥90 cm/s and PSV_BA/PSV_IVA ≥2.0 for 50%-69% BAS; PSV ≥210 cm/s, MFV ≥120 cm/s and PSV_BA/PSV_IVA ≥3.0 for 70%-99% BAS. The combination of PSV, MFV and PSV_BA/PSV_IVA may increase the accuracy for diagnosing 70%-99% BAS.