Transcranial Doppler characteristics of different embolic materials during in vivo testing.
OBJECTIVE
The authors investigated whether ultrasonic characteristics of embolic signals could be used to differentiate embolic composition.


METHODS
The authors analyzed high-intensity transient signals (HITS) from 3 patients with patent foramen ovale during the bubble contrast test and during total joint replacement surgery. In 3 anesthetized dogs, latex microspheres, fat particles, and air bubbles were injected into the internal carotid artery and HITS were identified in the cerebral circulation. The area under the receiver operating characteristic curve quantified the usefulness of each measure to distinguish embolic composition.


RESULTS
In humans, HITS intensity (area: 0.80) and frequency (area: 0.73) but not duration (area: 0.32) were useful to distinguish air bubbles from presumed solid emboli. In animals, intensity distinguished microspheres from air (area: 0.94) and microspheres from fat (area: 0.94) but was less useful for fat and air (area: 0.64). The duration (area: 0.54-0.76) and frequency (area: 0.54-0.63) were poor discriminators.


CONCLUSIONS
The HITS intensity best distinguished embolic composition. Particle size should be taken into account in future research.
Department of Anesthesia, Cardiac Division, University of Ottawa Heart Institute, Room H-341, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada. Rrodriguez@Ottawaheart.ca
Rosendo A
RA
Rodriguez
Allan
A
Giachino
Martin
M
Hosking
Howard J
HJ
Nathan
D000388:Air; D000818:Animals; D004285:Dogs; D004617:Embolism / Q000000981:diagnostic imaging*; D006801:Humans; D020766:Intracranial Embolism / Q000000981:diagnostic imaging; D008863:Microspheres; D010316:Particle Size; D012372:ROC Curve; D017585:Ultrasonography, Doppler, Transcranial