A Combined Power M-mode and Single Gate Transcranial Doppler Ultrasound Microemboli Signal Criteria for Improving Emboli Detection and Reliability

作者：Choi Youngbin; Sa**ur Maher; Asil Talip^*; Jin Albert; Stewart Eileen; Stephenson Caroline; Ibrahim Mohamad; Roy Jayanta; Boulanger Jean Martin; Coutts Shelagh; Khan Firosh; Demchuk Andrew M

来源：Journal of Neuroimaging, 2010, 20(4): 359-367.

DOI：10.1111/j.1552-6569.2009.00446.x

• microemboli
• transcranial doppler
• power M-mode
• diagnostic criteria

BACKGROUND AND PURPOSE
Single gate transcranial Doppler spectrogram (sgTCD) has a high variability in the detection of microembolic signals (MES), Adding Power M-mode Doppler (PMD) information may improve MES detection. Our study's aim is to derive combined PMD/sgTCD microemboli criteria to overcome this limitation.
METHODS
Patients with symptomatic carotid disease were prospectively enrolled within 24 h of symptom onset underwent 1 hour TCD emboli monitoring. We reviewed disparity between PMD MES criteria and sgTCD MES criteria. We compared combined PMD/sgTCD criteria to sgTCD alone criteria by measuring the intraclass correlation coefficient (ICC).
RESULTS
Of 92 patients, 28 patients had evidence of MES on sgTCD or PMD. Total MES count was 269 based on sgTCD criteria, and 326 based on combined PMD/sgTCD criteria (P = 0.005). Combined PMD/sgTCD criteria revealed 17 MESs (4.8%) based on sgTCD criteria to represent artifacts and 57 MESs (17.5%) not to be detected by sgTCD criteria. Overall ICC based on sgTCD criteria was 0.67 [95% confidence interval (CI): 0.58-0.74]; however, introducing combined PMD/sgTCD criteria resulted in a significant increase in the ICC, 0.91 (95% CI: 0.88-0.93).
CONCLUSION
Our combined PMD/sgTCD criteria for MES appeared to improve the yield of MES detection. Reliability in MES detection interpretation was improved when combined PMD/sgTCD criteria was applied.

• 出版日期2010-10
• 单位河北医科大学