• Junya Aoki, Kazumi Kimura, Yasuyuki Iguchi, Kensaku Shibazaki, Kazuto Kobayashi, Kenichiro Sakai, and Yuki Sakamoto.
• Department of Stroke Medicine, Kawasaki Medical School, Kurashiki, Japan. aojyun@med.kawasaki-m.ac.jp
• J Neuroimaging. 2012 Apr 1;22(2):172-6.

BackgroundWe investigated whether combined transcranial Doppler (TCD) and magnetic resonance angiography (MRA) can diagnose significant stenosis (s-stenosis) of the siphon portion of the internal carotid artery (S-ICA) on digital subtraction angiography (DSA).MethodsTCD criteria cut-off peak systolic blood-flow velocity of 75 cm/s or mean blood-flow velocity of 50 cm/s, with both values more than 30% higher than in the contralateral S-ICA. MRA criterion was defined as a ≥50% signal reduction of the column width. Combined TCD and MRA criteria were fulfillment of both TCD and MRA criteria.ResultsAmong 295 vessels, seven (2%) had s-stenosis on DSA. Using TCD criteria, 16 vessels (5%) were identified to have s-stenosis, of which six (38%) had s-stenosis on DSA (sensitivity, specificity, positive predictive value [PPV], and negative predictive value [NPV] were .86, .97, .38, and .99). Using MRA criteria, 17 (6%) vessels were s-stenosis, of which seven (41%) had s-stenosis on DSA. Sensitivity, specificity, and NPV were 1.00, .97, and 1.00; however, PPV was low (.41). Combined TCD and MRA criteria identified six (2%) vessels as having s-stenosis, all were s-stenosis on DSA (PPV was 1.00).ConclusionCombined TCD and MRA examinations have similar diagnostic power to DSA.Copyright © 2011 by the American Society of Neuroimaging.

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