PMID- 18821830
OWN - NLM
STAT- MEDLINE
DCOM- 20090224
LR  - 20161124
IS  - 0022-3085 (Print)
IS  - 0022-3085 (Linking)
VI  - 110
IP  - 1
DP  - 2009 Jan
TI  - Accuracy of transcranial Doppler ultrasonography and single-photon emission 
      computed tomography in the diagnosis of angiographically demonstrated cerebral 
      vasospasm.
PG  - 67-72
LID - 10.3171/2008.4.17520 [doi]
AB  - OBJECT: The goal of this study was to assess the accuracy of the routine clinical 
      use of transcranial Doppler (TCD) ultrasonography and SPECT in predicting 
      angiographically demonstrated vasospasm. METHODS: Following receipt of 
      institutional review board approval, the authors reviewed the records of patients 
      with subarachnoid hemorrhage who had been admitted between 2004 and 2005 and 
      underwent TCD ultrasonography and SPECT evaluations within 24 hours of cerebral 
      angiography. Patients were categorized based on the presence or absence of 
      vasospasm and/or hypoperfusion in the anterior cerebral arteries (ACAs), middle 
      cerebral arteries (MCAs), and basilar arteries (BAs) or posterior cerebral 
      arteries (PCAs) according to each imaging modality. Logistic regression was used 
      to estimate the odds ratio (OR) of an angiographically demonstrated vasospasm 
      also detected on TCD ultrasonography and SPECT. RESULTS: One hundred fifty-two 
      patients (101 women) with a mean age (+/- standard deviation) of 53 +/- 13 years 
      were included in the study. In the ACA, the OR of a vasospasm on TCD 
      ultrasonography was 27 (95% confidence interval [CI] 3-243) and on SPECT 0.97 
      (95% CI 0.36-2.6); in the MCA, 17 (95% CI 5.4-55) and 2.0 (95% CI 0.71-5.5), 
      respectively; in the BA, 4.4 (95% CI 0.72-27) and 5.6 (95% CI 0.89-36), 
      respectively. There was no substantial change in the relative odds of a vasospasm 
      when the findings on TCD ultrasonography and SPECT were considered jointly. 
      CONCLUSIONS: Transcranial Doppler ultrasonography appears to be highly predictive 
      of an angiographically demonstrated vasospasm in the MCA and ACA; however, its 
      diagnostic accuracy was lower with regard to vasospasm in the BA. Single-photon 
      emission computed tomography was not predictive of a vasospasm in any of the 
      vascular territories assessed.
FAU - Kincaid, M Sean
AU  - Kincaid MS
AD  - Department of Anesthesiology, Harborview Medical Center, Seattle, Washington 
      98104, USA. kincaid@u.washington.edu
FAU - Souter, Michael J
AU  - Souter MJ
FAU - Treggiari, Miriam M
AU  - Treggiari MM
FAU - Yanez, N David
AU  - Yanez ND
FAU - Moore, Anne
AU  - Moore A
FAU - Lam, Arthur M
AU  - Lam AM
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - J Neurosurg
JT  - Journal of neurosurgery
JID - 0253357
SB  - IM
MH  - Aged
MH  - Cerebral Angiography
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neurosurgical Procedures
MH  - Predictive Value of Tests
MH  - ROC Curve
MH  - Subarachnoid Hemorrhage/diagnosis/diagnostic imaging
MH  - *Tomography, Emission-Computed, Single-Photon
MH  - *Ultrasonography, Doppler, Transcranial
MH  - Vasospasm, Intracranial/*diagnosis/diagnostic imaging
MH  - Vertebrobasilar Insufficiency/diagnosis/diagnostic imaging
EDAT- 2008/09/30 09:00
MHDA- 2009/02/25 09:00
CRDT- 2008/09/30 09:00
PHST- 2008/09/30 09:00 [pubmed]
PHST- 2009/02/25 09:00 [medline]
PHST- 2008/09/30 09:00 [entrez]
AID - 10.3171/2008.4.17520 [doi]
PST - ppublish
SO  - J Neurosurg. 2009 Jan;110(1):67-72. doi: 10.3171/2008.4.17520.