BACKGROUND AND PURPOSE: Transcranial colour-coded sonography (TCCS) has been proven to be a method of high performance in the diagnosis of spasm of the middle cerebral artery (MCA). Relevant data concerning the anterior cerebral artery (ACA) varies amongst studies. The aim of this study was to assess the performance of TCCS in the diagnosis of spasm affecting the ACA. MATERIAL AND METHODS: Ninety-two patients (39 women and 53 men, age 51 ± 12.1 years) were examined using TCCS before cerebral angiography. Of 184 examined ACAs, only 133 arteries could be visualized due to insufficiency of the temporal acoustic window. Therefore, only 15 out of 25 arteries in which vasospasm was diagnosed with angiography (by two neuroradiologists not informed about the sonographic findings) could be included in the analysis. Receiver operating characteristic (ROC) curves were constructed for specific blood flow velocities: peak systolic (PSV), mean (M) and end-diastolic (EDV). The area under the ROC curve was used to measure the overall diagnostic performance of TCCS. RESULTS: The area under the ROC curve for PSV was 0.83, which indicates good performance. The PSV threshold of 98 cm/s corresponded to maximum accuracy and was associated with 71% sensitivity vs. 88% specificity. Average systolic blood flow velocity in the vessels with vasospasm was 129 cm/s, whereas in unaffected vessels it was 76 cm/s. CONCLUSIONS: The accuracy of TCCS in the diagnosis of ACA spasm is relatively high - the value of the area under the ROC amounts to 0.83. PSV performs best and the threshold of 98 cm/s is associated with an optimal trade-off between sensitivity and specificity.
BACKGROUND AND PURPOSE: Transcranial colour-coded sonography (TCCS) has been proven to be a method of high performance in the diagnosis of spasm of the middle cerebral artery (MCA). Relevant data concerning the anterior cerebral artery (ACA) varies amongst studies. The aim of this study was to assess the performance of TCCS in the diagnosis of spasm affecting the ACA. MATERIAL AND METHODS: Ninety-two patients (39 women and 53 men, age 51 ± 12.1 years) were examined using TCCS before cerebral angiography. Of 184 examined ACAs, only 133 arteries could be visualized due to insufficiency of the temporal acoustic window. Therefore, only 15 out of 25 arteries in which vasospasm was diagnosed with angiography (by two neuroradiologists not informed about the sonographic findings) could be included in the analysis. Receiver operating characteristic (ROC) curves were constructed for specific blood flow velocities: peak systolic (PSV), mean (M) and end-diastolic (EDV). The area under the ROC curve was used to measure the overall diagnostic performance of TCCS. RESULTS: The area under the ROC curve for PSV was 0.83, which indicates good performance. The PSV threshold of 98 cm/s corresponded to maximum accuracy and was associated with 71% sensitivity vs. 88% specificity. Average systolic blood flow velocity in the vessels with vasospasm was 129 cm/s, whereas in unaffected vessels it was 76 cm/s. CONCLUSIONS: The accuracy of TCCS in the diagnosis of ACA spasm is relatively high - the value of the area under the ROC amounts to 0.83. PSV performs best and the threshold of 98 cm/s is associated with an optimal trade-off between sensitivity and specificity.
Authors: Peter Le Roux; David K Menon; Giuseppe Citerio; Paul Vespa; Mary Kay Bader; Gretchen M Brophy; Michael N Diringer; Nino Stocchetti; Walter Videtta; Rocco Armonda; Neeraj Badjatia; Julian Böesel; Randall Chesnut; Sherry Chou; Jan Claassen; Marek Czosnyka; Michael De Georgia; Anthony Figaji; Jennifer Fugate; Raimund Helbok; David Horowitz; Peter Hutchinson; Monisha Kumar; Molly McNett; Chad Miller; Andrew Naidech; Mauro Oddo; DaiWai Olson; Kristine O'Phelan; J Javier Provencio; Corinna Puppo; Richard Riker; Claudia Robertson; Michael Schmidt; Fabio Taccone Journal: Intensive Care Med Date: 2014-08-20 Impact factor: 17.440
Authors: Peter Le Roux; David K Menon; Giuseppe Citerio; Paul Vespa; Mary Kay Bader; Gretchen M Brophy; Michael N Diringer; Nino Stocchetti; Walter Videtta; Rocco Armonda; Neeraj Badjatia; Julian Böesel; Randall Chesnut; Sherry Chou; Jan Claassen; Marek Czosnyka; Michael De Georgia; Anthony Figaji; Jennifer Fugate; Raimund Helbok; David Horowitz; Peter Hutchinson; Monisha Kumar; Molly McNett; Chad Miller; Andrew Naidech; Mauro Oddo; DaiWai Olson; Kristine O'Phelan; J Javier Provencio; Corinna Puppo; Richard Riker; Claudia Robertson; Michael Schmidt; Fabio Taccone Journal: Neurocrit Care Date: 2014-12 Impact factor: 3.210