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Classification of Intracranial Stenoses: Discrepancies between Transcranial Duplex Sonography and Computed Tomography Angiography.
Ultrasound in Medicine & Biology ( IF 2.4 ) Pub Date : 2020-05-19 , DOI: 10.1016/j.ultrasmedbio.2020.03.016
Leon Alexander Danyel 1 , Sara Hadzibegovic 1 , Jose Manuel Valdueza 2 , Anna Tietze 3 , Simon Fuchs 3 , Stephan J Schreiber 4 , Florian Connolly 1
Affiliation  

Transcranial color-coded duplex sonography (TCCS) and computed tomography angiography (CTA) are widely used to identify intracranial stenoses (ISs). We assessed concordance of IS grading between TCCS and CTA and proposed new TCCS criteria for severe IS ≥70%. One hundred two stroke patients (70 ± 13 y) with TCCS-identified IS were included. TCCS and CTA were performed within 24 h after admission. TCCS peak systolic velocity cutoffs for <50%/50%–69% stenoses were ≥155/≥220 cm/s (middle cerebral artery [MCA]-M1), ≥100/≥140 cm/s (MCA-M2), ≥120/≥155 cm/s (anterior cerebral artery [ACA]-A1), ≥100/≥145 cm/s (posterior cerebral artery [PCA]-P1 and PCA-P2), ≥90/≥120 cm/s (vertebral artery [VA]-V4) and ≥100/≥140 cm/s (basilar artery [BA]). Criteria for ≥70% stenoses were, despite variable flow velocities, post-stenotic flow alterations and/or leptomeningeal collateral flow. One hundred seventy-seven ISs were detected by TCCS. The number and grade (<50%/50%–69%/≥70%) of ISs were MCA 70 (39/19/12), BA 24 (9/11/4), ACA 21 (14/7/0), PCA 49 (29/15/5) and VA 13 (2/6/5). IS localization was confirmed by CTA in 84 of 177 cases (48%): MCA, 41/70 (59%); BA, 16/24 (67%); ACA 2/21, (10%); PCA, 17/49 (35%); VA, 8/13 (62%). Concordance between TCCS and CTA grading was (<50%/50%–69%/≥70%) 17%/19%/77%. TCCS and CTA exhibited substantial differences in the detection and grading of IS. Higher concordance rates for severe stenosis support our proposed TCCS criteria.



中文翻译:

颅内狭窄的分类:经颅双工超声和计算机断层扫描血管造影之间的差异。

经颅彩色编码双工超声 (TCCS) 和计算机断层扫描血管造影 (CTA) 被广泛用于识别颅内狭窄 (IS)。我们评估了 TCCS 和 CTA 之间 IS 分级的一致性,并提出了严重 IS ≥70% 的新 TCCS 标准。102 名患有 TCCS 鉴定的 IS 的中风患者 (70 ± 13 岁) 被包括在内。入院后 24 小时内进行 TCCS 和 CTA。<50%/50%–69% 狭窄的 TCCS 峰值收缩速度截止值≥155/≥220 cm/s(大脑中动脉 [MCA]-M1),≥100/≥140 cm/s(MCA-M2), ≥120/≥155 cm/s(大脑前动脉[ACA]-A1),≥100/≥145 cm/s(大脑后动脉[PCA]-P1和PCA-P2),≥90/≥120 cm/s (椎动脉 [VA]-V4) 和 ≥100/≥140 cm/s (基底动脉 [BA])。≥ 70% 狭窄的标准是,尽管流速可变,狭窄后血流改变和/或软脑膜侧支血流。TCCS 检测到 177 个 IS。IS 的数量和等级 (<50%/50%–69%/≥70%) 为 MCA 70 (39/19/12)、BA 24 (9/11/4)、ACA 21 (14/7/0) )、PCA 49 (29/15/5) 和 VA 13 (2/6/5)。177 例中的 84 例 (48%) 被 CTA 确认为 IS 定位:MCA,41/70 (59%);文学士,16/24(67%);ACA 2/21,(10%);PCA,17/49 (35%);弗吉尼亚州,8/13(62%)。TCCS 和 CTA 分级之间的一致性为 (<50%/50%–69%/≥70%) 17%/19%/77%。TCCS 和 CTA 在 IS 的检测和分级方面表现出显着差异。严重狭窄的较高一致性支持我们提出的 TCCS 标准。PCA 49 (29/15/5) 和 VA 13 (2/6/5)。177 例中的 84 例 (48%) 被 CTA 确认为 IS 定位:MCA,41/70 (59%);文学士,16/24(67%);ACA 2/21,(10%);PCA,17/49 (35%);弗吉尼亚州,8/13(62%)。TCCS 和 CTA 分级之间的一致性为 (<50%/50%–69%/≥70%) 17%/19%/77%。TCCS 和 CTA 在 IS 的检测和分级方面表现出显着差异。严重狭窄的较高一致性支持我们提出的 TCCS 标准。PCA 49 (29/15/5) 和 VA 13 (2/6/5)。177 例中的 84 例 (48%) 被 CTA 确认为 IS 定位:MCA,41/70 (59%);文学士,16/24(67%);ACA 2/21,(10%);PCA,17/49 (35%);弗吉尼亚州,8/13(62%)。TCCS 和 CTA 分级之间的一致性为 (<50%/50%–69%/≥70%) 17%/19%/77%。TCCS 和 CTA 在 IS 的检测和分级方面表现出显着差异。严重狭窄的较高一致性支持我们提出的 TCCS 标准。

更新日期:2020-06-25
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