title: Transcranial Doppler ultrasound for screening cerebral small vessel disease: a community study.
abstract: OBJECTIVE
  We explored the association between pulsatility index (PI) as derived from transcranial Doppler ultrasound with various measures of small vessel disease in the community.
  
  
  METHODS
  We performed transcranial Doppler and magnetic resonance imaging in 205 consecutive community-dwelling elderly subjects who were participants of the Shanghai Aging Study. We investigated the association between middle cerebral artery (MCA) PI with measures of white matter lesions (WML), lacunes, and microbleeds.
  
  
  RESULTS
  Multiple logistic regression found that MCA PI was associated with severe WML (odds ratio, 1.33 per 0.1 increase in PI; 95% confidence interval, 1.04-1.70; P=0.02). At optimal MCA PI cut-off, the area under curve, positive predictive value, and negative predictive value were 0.70 (95% confidence interval, 0.60-0.80), 34.9%, and 85.6%, respectively, for detection of severe WML. No association was found between MCA PI and measures of lacunes or microbleeds.
  
  
  CONCLUSIONS
  PI correlates with WML severity. With a high negative predictive value, the chance of having severe WML with a normal PI is low. Transcranial Doppler may guide selective magnetic resonance imaging scanning for the detection of WML in the community.
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China. vctmok@cuhk.edu.hk
authors.forename: Vincent
authors.initials: V
authors.lastname: Mok
authors.forename: Ding
authors.initials: D
authors.lastname: Ding
authors.forename: Jianhui
authors.initials: J
authors.lastname: Fu
authors.forename: Yunyun
authors.initials: Y
authors.lastname: Xiong
authors.forename: Winnie W C
authors.initials: WW
authors.lastname: Chu
authors.forename: Defeng
authors.initials: D
authors.lastname: Wang
authors.forename: Jill M
authors.initials: JM
authors.lastname: Abrigo
authors.forename: Jie
authors.initials: J
authors.lastname: Yang
authors.forename: Adrian
authors.initials: A
authors.lastname: Wong
authors.forename: Qianhua
authors.initials: Q
authors.lastname: Zhao
authors.forename: Qihao
authors.initials: Q
authors.lastname: Guo
authors.forename: Zhen
authors.initials: Z
authors.lastname: Hong
authors.forename: Ka Sing
authors.initials: KS
authors.lastname: Wong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059345:Cerebral Small Vessel Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002681:China; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D011237:Predictive Value of Tests; D063177:Pulse Wave Analysis; D012189:Retrospective Studies; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*