Can transcranial Doppler ultrasound be used for screening cerebral small vessel diseases in the community?
Publication in policy or professional journal

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其它資訊
摘要Objectives
Elderly persons harbouring severe white matter hyperintensity (WMH), a radiological manifestation of cerebral small vessel disease (SVD), have an increased risk of dementia, stroke and poor functional outcomes. A simple screening tool will enhance their recruitment into preventive trials for SVD. We explored the clinical utility of the pulsatility index (PI) of the middle cerebral artery (MCA), obtained from transcranial Doppler ultrasound (TCD), in identifying severe WMH among community elderly persons with vascular risk factors.

Methods
Three hundred and thirty-one dementia- and stroke-free community elderly subjects with hypertension and/or diabetes mellitus underwent TCD to obtain the MCA PI. The WMH volume on 3.0 Tesla MRI was quantified and normalized to each subject's brain volume. The normalized WMH volumes were classified as low (<14.5 ml, 1 standard deviation [SD] above the mean, 84th percentile) or high (≥14.5 ml). The severity of WMH was also rated visually with the Fazekas score. Logistic regression and receiver-operator characteristics (ROC) analysis were performed to evaluate the association between the MCA PI and the severity of WMH.

Results
The MCA PI was not an independent predictor of severe WMH. An MCA PI ≥1.095 detected high normalized WMH volumes with an area under the curve (AUC) of 0.553 (95% CI 0.473–0.633), sensitivity of 0.556, and specificity of 0.523. ROC analysis of the MCA PI in predicting high Fazekas scores yielded similar findings.

Conclusion
In stroke- and dementia-free elderly persons with vascular risk factors, the MCA PI was unable to identify severe WMH. (Word count: 260).
著者Kang D, Wong A, Fu J, Qun X, Liu W, Wang Z, Lin S, Kwan P, Lo E, Au LWC, Ko H, Lau AYL, Leung TWH, Abrigo J, Chu WCW, Mok VCT, Lam BYK
期刊名稱Journal of the Neurological Sciences
出版年份2019
月份11
日期15
卷號406
文章號碼116439
國際標準期刊號0022-510X
電子國際標準期刊號1878-5883
語言美式英語
關鍵詞Screening; Small vessel diseases; Transcranial Doppler ultrasound; Vascular dementia; White matter hyperintensity

上次更新時間 2020-08-07 於 01:41