title: Transcranial Doppler ultrasonography to evaluate need for cerebrospinal fluid drainage in hydrocephalic children.
abstract: The aim of this study was to determine whether the resistive index in the anterior cerebral artery, as measured by transcranial Doppler ultrasonography without and with pressure provocation, predicts the need for cerebrospinal fluid drainage in hydrocephalic children. Both without and with pressure provocation, the resistive index was significantly higher (P > 0.05) in patients with raised intracranial pressure compared with control group patients and dropped significantly after drainage. With receiver operating characteristic analysis, the optimal cutoff point between normal and abnormal resistive index values was determined at 0.71 without pressure provocation and at 0.90 with pressure provocation. The addition of the pressure provocation test improved accuracy from 81 to 91%, mainly by improving specificity. In conclusion, transcranial Doppler ultrasonography with pressure provocation accurately identifies hydrocephalic children who require cerebrospinal fluid drainage procedures.
authors.affiliation: Department of Radiological Sciences, UCLA School of Medicine, Los Angeles, California 90095-1721, USA.
authors.forename: S J
authors.initials: SJ
authors.lastname: Westra
authors.forename: J
authors.initials: J
authors.lastname: Lazareff
authors.forename: J G
authors.initials: JG
authors.lastname: Curran
authors.forename: J W
authors.initials: JW
authors.lastname: Sayre
authors.forename: H
authors.initials: H
authors.lastname: Kawamoto
mesh_terms: D002557:Cerebrospinal Fluid Shunts; D002648:Child; D002675:Child, Preschool; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging* / Q000601:surgery; D007223:Infant; D007231:Infant, Newborn; D007427:Intracranial Pressure; D008297:Male; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D017585:Ultrasonography, Doppler, Transcranial