Abstract

Transcranial Doppler ultrasonography of the middle cerebral artery (MCA) is frequently used to assess dynamic cerebral autoregulation (dCA); however, this is difficult in patients with poor temporal bone windows. In the study described here, we investigated the agreement and sensitivity of dCA indices determined from the extracranial internal carotid artery (ICA) and those determined from the MCA. Measurements for 32 stroke patients and 59 controls were analyzed. Measurement of the mean flow correlation index (Mx) and transfer function analysis based on spontaneous blood pressure fluctuation were simultaneously performed for the extracranial ICA and MCA. The mean values of Mx and phase shift did not significantly differ between the ICA and MCA (mean difference: Mx = 0.01; phase shift of very low frequency [VLF] = 0.7°, low frequency [LF] = 3.3° and high frequency = 4.5°), but the gains in VLF and LF in the ICA were significantly lower than those in the MCA (mean difference: gain of VLF = −0.13, gain of LF = −0.10). The intra-class correlation coefficient between the dCA indices of the ICA and MCA was favorable in Mx (0.76) and the phase shift of VLF (0.72). The area under the receiver operating characteristic curve for stroke diagnosis did not differ among the dCA indices. We conclude that dCA assessed from the ICA is as effective as that from the MCA, but the results are not interchangeable.

Original languageEnglish
Pages (from-to)1307-1313
Number of pages7
JournalUltrasound in Medicine and Biology
Volume43
Issue number7
DOIs
Publication statusPublished - Jul 1 2017

Fingerprint

Doppler Ultrasonography
Middle Cerebral Artery
Internal Carotid Artery
arteries
Homeostasis
very low frequencies
Stroke
Doppler Transcranial Ultrasonography
phase shift
Temporal Bone
low frequencies
strokes
ROC Curve
blood pressure
Blood Pressure
correlation coefficients
transfer functions
bones

Keywords

  • Cerebral hemodynamics
  • Cerebrovascular diseases
  • Dynamic cerebral autoregulation
  • Transcranial Doppler ultrasonography

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Biophysics
  • Radiology Nuclear Medicine and imaging

Cite this

Dynamic Cerebral Autoregulation Assessment Using Extracranial Internal Carotid Artery Doppler Ultrasonography. / Chi, Nai Fang; Ku, Hsiao Lun; Wang, Chen Yen; Liu, Yanhui; Chan, Lung; Lin, Ying Chin; Peng, Chung Kang; Novak, Vera; Hu, Han Hwa; Hu, Chaur Jong.

In: Ultrasound in Medicine and Biology, Vol. 43, No. 7, 01.07.2017, p. 1307-1313.

Research output: Contribution to journalArticle

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AU - Chi, Nai Fang

AU - Ku, Hsiao Lun

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AU - Liu, Yanhui

AU - Chan, Lung

AU - Lin, Ying Chin

AU - Peng, Chung Kang

AU - Novak, Vera

AU - Hu, Han Hwa

AU - Hu, Chaur Jong

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AB - Transcranial Doppler ultrasonography of the middle cerebral artery (MCA) is frequently used to assess dynamic cerebral autoregulation (dCA); however, this is difficult in patients with poor temporal bone windows. In the study described here, we investigated the agreement and sensitivity of dCA indices determined from the extracranial internal carotid artery (ICA) and those determined from the MCA. Measurements for 32 stroke patients and 59 controls were analyzed. Measurement of the mean flow correlation index (Mx) and transfer function analysis based on spontaneous blood pressure fluctuation were simultaneously performed for the extracranial ICA and MCA. The mean values of Mx and phase shift did not significantly differ between the ICA and MCA (mean difference: Mx = 0.01; phase shift of very low frequency [VLF] = 0.7°, low frequency [LF] = 3.3° and high frequency = 4.5°), but the gains in VLF and LF in the ICA were significantly lower than those in the MCA (mean difference: gain of VLF = −0.13, gain of LF = −0.10). The intra-class correlation coefficient between the dCA indices of the ICA and MCA was favorable in Mx (0.76) and the phase shift of VLF (0.72). The area under the receiver operating characteristic curve for stroke diagnosis did not differ among the dCA indices. We conclude that dCA assessed from the ICA is as effective as that from the MCA, but the results are not interchangeable.

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