PT - JOURNAL ARTICLE AU - Ogata, Toshiyasu AU - Kimura, Kazumi AU - Nakajima, Makoto AU - Ikeno, Kouichi AU - Naritomi, Hiroaki AU - Minematsu, Kazuo TI - Transcranial Color-Coded Real-Time Sonographic Criteria for Occlusion of the Middle Cerebral Artery in Acute Ischemic Stroke DP - 2004 Nov 01 TA - American Journal of Neuroradiology PG - 1680--1684 VI - 25 IP - 10 4099 - http://www.ajnr.org/content/25/10/1680.short 4100 - http://www.ajnr.org/content/25/10/1680.full SO - Am. J. Neuroradiol.2004 Nov 01; 25 AB - BACKGROUND AND PURPOSE: Transcranial color-coded real-time sonography (TCCS) is a useful tool to evaluate disease of the middle cerebral artery (MCA). This study was undertaken to identify TCCS criteria for the diagnosis of MCA stem and MCA branch occlusions.METHODS: TCCS and digital subtraction angiography were performed in 55 consecutive patients with acute stroke: 10 with MCA stem occlusion, the MO group; eight with MCA branch occlusion, the MB group; and 37 with nonocclusive lesions, the control group. We measured the end-diastolic velocity (EDV) of the bilateral MCA stems and calculated the end-diastolic ratio by dividing the EDV of the unaffected side by that of the affected side.RESULTS: EDV was highest in the control group, and end-diastolic ratio was highest in the MO group. An EDV of >25 cm/s indicated a nonocclusive lesion in the MCA, with a positive predictive value of 98.4%, a negative predictive value of 81.0%, and an accuracy of 93.9%. An EDV of ≤25 cm/s with an end-diastolic ratio of <2.7 indicated an MCA branch occlusion with a positive predictive value of 85.7%, a negative predictive value of 97.2%, and an accuracy of 95.3%. An EDV of ≤25 cm/s with an end-diastolic ratio of ≥2.7 indicated MCA stem occlusion with a positive predictive value of 100%, a negative predictive value of 100%, and an accuracy of 100%.CONCLUSION: We developed TCCS criteria for the diagnosis of MCA diseases. MCA flow velocity detected by means of TCCS can help identify MCA stem occlusion as well as MCA branch occlusion.