title: Accuracy of transcranial colour-coded sonography in the diagnosis of anterior cerebral artery vasospasm.
abstract: OBJECTIVE
  Transcranial colour-coded sonography (TCCS) has been proven to be a method of high performance in the diagnosis of spasm of the middle cerebral artery (MCA). Relevant data concerning the anterior cerebral artery (ACA) varies amongst studies. The aim of this study was to assess the performance of TCCS in the diagnosis of spasm affecting the ACA.
  
  
  METHODS
  Ninety-two patients (39 women and 53 men, age 51 ± 12.1 years) were examined using TCCS before cerebral angiography. Of 184 examined ACAs, only 133 arteries could be visualized due to insufficiency of the temporal acoustic window. Therefore, only 15 out of 25 arteries in which vasospasm was diagnosed with angiography (by two neuroradiologists not informed about the sonographic findings) could be included in the analysis. Receiver operating characteristic (ROC) curves were constructed for specific blood flow velocities: peak systolic (PSV), mean (M) and end-diastolic (EDV). The area under the ROC curve was used to measure the overall diagnostic performance of TCCS.
  
  
  RESULTS
  The area under the ROC curve for PSV was 0.83, which indicates good performance. The PSV threshold of 98 cm/s corresponded to maximum accuracy and was associated with 71% sensitivity vs. 88% specificity. Average systolic blood flow velocity in the vessels with vasospasm was 129 cm/s, whereas in unaffected vessels it was 76 cm/s.
  
  
  CONCLUSIONS
  The accuracy of TCCS in the diagnosis of ACA spasm is relatively high - the value of the area under the ROC amounts to 0.83. PSV performs best and the threshold of 98 cm/s is associated with an optimal trade-off between sensitivity and specificity.
authors: Department of Neurosurgery, Medical University of Bialystok, Skłodowskiej-Curie 24a, 15-276 Bialystok, Poland. turekgrzegorz@vp.pl
authors: Grzegorz
authors: G
authors: Turek
authors: Jan
authors: J
authors: Kochanowicz
authors: Robert
authors: R
authors: Rutkowski
authors: Jarosław
authors: J
authors: Krejza
authors: Tomasz
authors: T
authors: Lyson
authors: Krzysztof
authors: K
authors: Gorbacz
authors: Justyna
authors: J
authors: Zielinska-Turek
authors: Zenon
authors: Z
authors: Mariak
mesh_terms: D000328:Adult; D000368:Aged; D020771:Anterior Cerebral Artery / Q000000981:diagnostic imaging* / Q000473:pathology; D001783:Blood Flow Velocity; D002560:Cerebrovascular Circulation; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*; D020301:Vasospasm, Intracranial / Q000000981:diagnostic imaging* / Q000473:pathology