Transcranial Doppler in asymptomatic carotid stenosis representing hemodynamic impairment: correlation study with magnetic resonance imaging.
OBJECTIVE
Since the benefit of an endarterectomy in an asymptomatic carotid stenosis is not as clear as that in symptomatic stenosis, identifying patients with a high risk of stroke will allow the improved selection of surgical candidates. To evaluate the role of transcranial Doppler (TCD) in assessing an asymptomatic stenosis, this study examined the association of a TCD-detected hemodynamic change with a stenosis-related abnormality on magnetic resonance imaging (MRI).


METHODS
Asymptomatic patients with a more than 60% internal carotid artery stenosis were enrolled in this study. The hemodynamic change in the TCD was analyzed in terms of the demographic characteristics, the stroke risk factors, and the stenosis-related MRI abnormalities that are a proven risk factor of a further stroke.


RESULTS
Fifty-three patients were retrospectively recruited. While there were no differences in the demographic characteristics or frequency of the stroke risk factors, the proportion of patients with stenosis-related MRI abnormality was significantly higher in patients with a hemodynamic change on TCD (13/19 vs 6/34, P < .01; odds ratio = 10.11; 95% confidence interval = 2.73-37.4).


CONCLUSIONS
The TCD-detected hemodynamic changes may provide useful information for assessing the frequency of silent stroke in patients with an asymptomatic carotid stenosis.
Kim
Dong Wook
DW
Department of Neurology, Seoul Municipal Boramae Hospital, Korea.
Min
Ju-Hong
JH
Lee
Yong-Seok
YS
D000368:Aged; D002343:Carotid Artery, Internal; D016893:Carotid Stenosis / Q000175:diagnosis / Q000000981:diagnostic imaging*; D016009:Chi-Square Distribution; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000517:prevention & control; D017585:Ultrasonography, Doppler, Transcranial