title: The value of transcranial Doppler derived pulsatility index for diagnosing cerebral small-vessel disease.
abstract: BACKGROUND
  The pulsatility index (PI), measured by transcranial Doppler (TCD) ultrasonography, can reflect vascular resistance induced by cerebral small-vessel disease (SVD). We evaluated the value of TCD-derived PI for diagnosing SVD as compared with magnetic resonance imaging (MRI).
  
  
  METHODS
  Fifty-six consecutive cases with SVD (based on MRI) and 48 controls with normal MRI underwent TCD. Based on MRI findings, patients were categorized into five subgroups of preventricular hyperintensity (PVH), deep white matter hyperintensity (DWMH), lacunar, pontin hyperintensity (PH), and PVH+DWMH+lacunar. The sensitivity and specificity of TCD in best PI cut-off points were calculated in each group.
  
  
  RESULTS
  The sensitivity and specificity of TCD in comparison with MRI with best PI cut-off points were as follows: In PVH with PI = 0.83, the sensitivity and specificity was 90% and 98%, respectively. In DWMH with PI = 0.79, the sensitivity and specificity was 75% and 87.5%, respectively. In lacunar with PI = 0.80, the sensitivity and specificity was 73% and 90%, respectively. In PH with PI = 0.69, the sensitivity and specificity was 92% and 87.5%, respectively. And, in PVH+DWMH+lacunar subgroup with PI = 0.83, the sensitivity and specificity was 90% and 96%, respectively.
  
  
  CONCLUSIONS
  Increased TCD derived PI can accurately indicate the SVD. Hence, TCD can be used as a non-invasive and inexpensive method for diagnosing SVD, and TCD-derived PI can be considered as a physiologic index of the disease as well.
authors: Department of Neurology, Isfahan Neuroscience Research Center, Medical Students' Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Abbas
authors: A
authors: Ghorbani
authors: Department of Neurology, Isfahan Neuroscience Research Center, Medical Students' Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Mohammad Javad
authors: MJ
authors: Ahmadi
authors: Department of Neurology, Isfahan Neuroscience Research Center, Medical Students' Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Hamidreza
authors: H
authors: Shemshaki
keywords: Cerebral small-vessel disease; diagnosis; pulsatility index; small-vessel disease; transcranial Doppler ultrasonography; vascular resistance