Transcranial Doppler pulsatility indices as a measure of diffuse small-vessel disease
Transcranial Doppler pulsatility indices as a measure of diffuse small-vessel disease
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DOI：
10.1111/j.1552-6569.2001.tb00039.x
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发表时间：
2001-07-01
影响因子：
2.4
通讯作者：
Saver, JL
中科院分区：
文献类型：
--
作者：
Kidwell, CS;El-Saden, S;Saver, JL
背景和目的。经颅多普勒 (TCD) 测量的搏动指数 (Pls) 升高被认为反映了小血管缺血性疾病引起的下游血管阻力增加。方法。作者回顾性比较了 55 名连续 55 名患者的小血管疾病的 TCD Pls 和磁共振成像 (MRI) 表现，这些患者在 2 年期间在 6 个月内接受了 TCD 研究和脑 MRI。结果。 TCD 大脑中动脉 Pls 和 MRI 测量值之间的相关性如下：脑室周围高信号 (PVH) = 0.52 (P < .0001)，深部白质高信号 (DWMH) = = 0.54 (P < .0001)，腔隙疾病 = 0.31 (P = .02)，PVH/DWMH/腔隙组合 = 0.54 (P < .0001)。 .0001）。脑桥缺血与椎基底动脉 Pls 之间的相关性为 0.46 (P = .0004)。单变量分析表明，年龄、PI 升高和高血压与白质疾病指标密切相关。在多元泊松回归分析中调整这些因素后，PI 仍然是白质疾病的独立预测因子。接受者操作曲线分析确定了 PI 切点，可以以 89% 的敏感性和 86% 的特异性区分 PVH，以 70% 的敏感性和 73% 的特异性区分 DWMH。结论。 TCD 测量的 Pls 升高与小血管疾病的 MRI 证据有很强的相关性。 TCD 可能是弥漫性小血管疾病的存在和严重程度的有用生理指标。
Background and Purpose. Elevation in pulsatility indices (Pls) as measured by transcranial Doppler (TCD) have been postulated to reflect downstream increased vascular resistance caused by small-vessel ischemic disease. Methods. The authors retrospectively compared TCD Pls and magnetic resonance imaging (MRI) manifestations of small-vessel disease in 55 consecutive patients who underwent TCD studies and brain MRI within 6 months of each other during a 2-year period. Results. Correlations between TCD middle cerebral artery Pls and MRI measures were as follows: periventricular hyperintensity (PVH) = 0.52 (P < .0001), deep white matter hyperintensity (DWMH) = = 0.54 (P < .0001), lacunar disease = 0.31 (P = .02), and combined PVH/DWMH/lacunes = 0.54 (P < .0001). Correlation between pontine ischemia and vertebrobasilar Pls was 0.46 (P = .0004). Univariate analysis showed that age, elevated PI, and hypertension strongly correlated with white matter disease measures. After adjusting for these factors in a multivariate Poisson regression analysis, PI remained an independent predictor of white matter disease. Receiver operator curve analyses identified PI cut points that allowed discrimination of PVH with 89% sensitivity and 86% specificity and discrimination of DWMH with 70% sensitivity and 73% specificity. Conclusions. Elevation in Pls as measured by TCD shows strong correlation with MRI evidence of small-vessel disease. TCD may be a useful physiologic index of the presence and severity of diffuse small-vessel disease.