title: Reevaluating the transcranial Doppler criteria for estimation of anterior circulation artery stenosis: transcranial Doppler sonography versus digital subtraction angiography.
abstract: OBJECTIVE
  The criteria for evaluating cerebral artery stenosis by transcranial Doppler sonography are inconsistent. We aimed to identify the accuracy of transcranial Doppler criteria compared with digital subtraction angiography for diagnosis of anterior circulation artery stenosis.
  
  
  METHODS
  A total of 170 patients who underwent transcranial Doppler sonography and digital subtraction angiography were recruited. The anterior circulation arteries were evaluated by transcranial Doppler sonography and digital subtraction angiography. We defined the best cutoff value for substantial anterior circulation artery stenosis by receiver operating characteristic curve analyses and calculated the sensitivity, specificity, and positive and negative predictive values.
  
  
  RESULTS
  An anterior circulation artery peak systolic velocity (PSV) of 120 cm/s had the largest area under the receiver operating characteristic curve compared with PSVs of 110, 130, and 140 cm/s and mean flow velocities of 60, 70, and 80 cm/s. The sensitivity, specificity, false-positive rate, false-negative rate, accuracy, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and Youden index for transcranial Doppler sonography were 90.6%, 85.0%, 15.0%, 9.4%, 87.9%, 87.2%, 88.9%, 6.04, 0.11, and 0.756, respectively. The reliability index included the agreement rate and κ value, which were 87.9% and 0.757.
  
  
  CONCLUSIONS
  A PSV of 120 cm/s combined with additional parameters was an accurate criterion for diagnosing anterior circulation artery stenosis. Transcranial Doppler sonography could be considered a valuable method for screening diagnosis of cerebral artery stenosis.
authors: Institute of Neuroscience, Second Affiliated Hospital, Guangzhou Medical University, 510000 Guangzhou, China.
authors: Xian
authors: X
authors: Fu
authors: Jianrui
authors: J
authors: Yin
authors: Ka Sing
authors: KS
authors: Wong
authors: Cong
authors: C
authors: Gao
mesh_terms: D015901:Angiography, Digital Subtraction / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging*; D002536:Cerebral Arteries / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*