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Updated: Nov 3, 2025
Functional Transcranial Doppler Ultrasound for Monitoring Cerebral Blood Flow
Published on: March 15, 2021
Cerebral Hemodynamic Evaluation of Main Cerebral Vessels in Epileptic Patients Based on Transcranial Doppler
Jihong Meng1, Chun Li2, Weining Ma1
1Department of Neurosurgery, Shengjing Hospital of China Medical University, Shenyang, China.
Insights
In epilepsy patients, cerebral blood flow velocity (both peak and mean) was lower in major vessels on the side with lower metabolism (PET) or abnormal brain activity (EEG). This difference, especially in the posterior cerebral artery, may help locate the seizure focus.
Area of Science:
- Neurology
- Neuroimaging
- Cerebrovascular Physiology
Background:
- Epilepsy is a neurological disorder characterized by recurrent seizures.
- Assessing cerebral hemodynamics is crucial for understanding brain function in epilepsy.
- FDG-PET-CT and EEG are key diagnostic tools in epilepsy evaluation.
Purpose of the Study:
- To investigate differences in peak and mean blood flow velocity (PFV, MFV) in major cerebral arteries between epilepsy patients' left and right sides.
- To correlate these hemodynamic differences with patterns observed in FDG-PET-CT and interictal EEG.
Main Methods:
- Sixteen epilepsy patients underwent FDG-PET-CT and EEG.
- Transcranial Doppler (TCD) measured PFV and MFV in bilateral anterior, middle, and posterior cerebral arteries.
- Hemodynamic data were compared between sides based on PET hypometabolism and EEG discharge locations.
Main Results:
- Cerebral vessels supplying hypometabolic regions on PET showed lower PFV and MFV compared to the contralateral side.
- Vessels on the side with interictal EEG discharges also exhibited lower PFV and MFV than the opposite side.
- Mean flow velocity (MFV) in the posterior cerebral artery showed a statistically significant difference between sides in relation to PET hypometabolism or EEG discharge (P < 0.05).
Conclusions:
- Epileptic patients demonstrate reduced PFV and MFV in major cerebral vessels on sides identified as hypometabolic by PET or showing interictal EEG discharges.
- The observed differences in cerebral blood flow velocity may aid in lateralizing the epileptogenic zone.
- MFV differences in the posterior cerebral artery show particular promise for lateral diagnosis.
Abstract:
Objective: To study whether there is a difference in peak and mean blood flow velocity between the left and right major cerebral vessels in patients with epilepsy. Methods: Sixteen patients with epilepsy underwent FDG18-PET-CT (PET) scan and electroencephalogram (EEG) examinations. Transcranial Doppler (TCD) was used to detect the peak flow velocity (PFV), mean flow velocity (MFV), and other hemodynamic indicators of bilateral anterior, middle, and posterior cerebral arteries in each patient. According to different patterns of the PET or interictal EEG, the differences in PFV, and MFV of corresponding vessels on both sides under different patterns were compared. Results: According to the PET of the low-metabolism region corresponding to the supplying artery, the PFV and MFV of the supplying artery in the low-metabolism region were lower than the value of the corresponding contralateral vessel. The PFV and MFV on the low metabolic side of PET were lower than that of the corresponding vessels on the opposite side. The PFV and MFV on the discharge side of interictal EEG were also lower than the PFV and MFV of the corresponding vessels on the opposite side. The MFV of posterior cerebral artery on the low metabolic side of PET or the interictal discharge side was significantly different from that of the contralateral vessels (P < 0.05). However, the other aforementioned differences in PFV and MFV did not achieve statistical significance. Conclusion: In epileptic patients, the PFV and MFV of main cerebral vessels on the PET hypometabolized side or the interictal discharge side was lower than that of corresponding vessels on the contralateral side. To some extent, the difference in the MFV of PCA between the bilateral sides can facilitate the lateral diagnosis of the epileptogenic zone.
