Detection of high intensity transient signals (HITS): How and why?
HITS (high intensity transient signals) in transcranial Doppler recordings reflect either microemboli, both gaseous and solid, or artefacts. Various frequencies in number of microembolic signals (MES) have been reported in the same clinical condition. A possible explanation for these discrepancies m...
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Published in | European Journal of Ultrasound Vol. 7; no. 1; pp. 23 - 29 |
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Main Authors | , |
Format | Book Review Journal Article |
Language | English |
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Elsevier Ireland Ltd
01.02.1998
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Abstract | HITS (high intensity transient signals) in transcranial Doppler recordings reflect either microemboli, both gaseous and solid, or artefacts. Various frequencies in number of microembolic signals (MES) have been reported in the same clinical condition. A possible explanation for these discrepancies may be different device settings and algorithms for embolus detection. For reproducibility of data, we suggest that studies on MES report the following parameters: (1) Ultrasound device; (2) transducer type; (3) insonated artery; (4) insonation depth; (5) algorithms for signal intensity measurement; (6) scale settings; (7) detection threshold; (8) axial extension of sample volume; (9) fast Fourier transform (FFT) size (number of points used); (10) FFT length (time); (11) FFT overlap; (12) transmitted ultrasound frequency; (13) high pass filter settings; and (14) recording time. No current system of automatic embolus detection has the full sensitivity and specificity required for clinical use. Therefore, each of the signals detected by these devices needs to be checked and verified by an experienced investigator. MES will help to identify the site and activity of the embolizing lesion. Microembolus detection might reduce the observation time and the number of patients needed to perform interventional trials. First, however, MES needs to be validated as a meaningful prognostic parameter. Microemboli originating from prosthetic cardiac valves are mainly gaseous. Therefore, they cannot serve as an indicator of the valves thromboembolic activity or the patient’s stroke risk. |
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AbstractList | HITS (high intensity transient signals) in transcranial Doppler recordings reflect either microemboli, both gaseous and solid, or artefacts. Various frequencies in number of microembolic signals (MES) have been reported in the same clinical condition. A possible explanation for these discrepancies may be different device settings and algorithms for embolus detection. For reproducibility of data, we suggest that studies on MES report the following parameters: (1) Ultrasound device; (2) transducer type; (3) insonated artery; (4) insonation depth; (5) algorithms for signal intensity measurement; (6) scale settings; (7) detection threshold; (8) axial extension of sample volume; (9) fast Fourier transform (FFT) size (number of points used); (10) FFT length (time); (11) FFT overlap; (12) transmitted ultrasound frequency; (13) high pass filter settings; and (14) recording time. No current system of automatic embolus detection has the full sensitivity and specificity required for clinical use. Therefore, each of the signals detected by these devices needs to be checked and verified by an experienced investigator. MES will help to identify the site and activity of the embolizing lesion. Microembolus detection might reduce the observation time and the number of patients needed to perform interventional trials. First, however, MES needs to be validated as a meaningful prognostic parameter. Microemboli originating from prosthetic cardiac valves are mainly gaseous. Therefore, they cannot serve as an indicator of the valves thromboembolic activity or the patient’s stroke risk. |
Author | Ringelstein, E.Bernd Droste, Dirk W |
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BackLink | https://www.ncbi.nlm.nih.gov/pubmed/9614287$$D View this record in MEDLINE/PubMed |
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Keywords | Prosthetic cardiac values Stroke Transcranial Doppler High intensity transient signals |
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References | Russell (BIB18) 1992 Spencer (BIB22) 1990; 21 Droste (BIB9) 1997; 28 Markus (BIB14) 1993; 24 Siebler (BIB20) 1995; 26 Babikian (BIB1) 1994; 25 Braekken (BIB2) 1995; 26 Markus (BIB17) 1995; 118 Bush, Evans (BIB3) 1993; 14 Droste (BIB6) 1994; 4 Siebler (BIB21) 1992; 23 (BIB10) 1991; 337 Markus (BIB15) 1996; 27 Grosset (BIB12) 1994; 25 Droste (BIB7) 1996; 18 Siebler (BIB19) 1993; 116 Grosset (BIB11) 1994; 3 (BIB5) 1995; 26 Casty (BIB4) 1994; 15 Kaps (BIB13) 1997; 28 Markus, Molloy (BIB16) 1997; 28 Droste (BIB8) 1997; 28 Droste (10.1016/S0929-8266(98)00010-X_BIB8) 1997; 28 Droste (10.1016/S0929-8266(98)00010-X_BIB9) 1997; 28 (10.1016/S0929-8266(98)00010-X_BIB10) 1991; 337 Grosset (10.1016/S0929-8266(98)00010-X_BIB11) 1994; 3 Russell (10.1016/S0929-8266(98)00010-X_BIB18) 1992 Casty (10.1016/S0929-8266(98)00010-X_BIB4) 1994; 15 Siebler (10.1016/S0929-8266(98)00010-X_BIB19) 1993; 116 Braekken (10.1016/S0929-8266(98)00010-X_BIB2) 1995; 26 Babikian (10.1016/S0929-8266(98)00010-X_BIB1) 1994; 25 Grosset (10.1016/S0929-8266(98)00010-X_BIB12) 1994; 25 (10.1016/S0929-8266(98)00010-X_BIB5) 1995; 26 Siebler (10.1016/S0929-8266(98)00010-X_BIB21) 1992; 23 Markus (10.1016/S0929-8266(98)00010-X_BIB14) 1993; 24 Markus (10.1016/S0929-8266(98)00010-X_BIB15) 1996; 27 Droste (10.1016/S0929-8266(98)00010-X_BIB7) 1996; 18 Kaps (10.1016/S0929-8266(98)00010-X_BIB13) 1997; 28 Markus (10.1016/S0929-8266(98)00010-X_BIB17) 1995; 118 Droste (10.1016/S0929-8266(98)00010-X_BIB6) 1994; 4 Markus (10.1016/S0929-8266(98)00010-X_BIB16) 1997; 28 Bush (10.1016/S0929-8266(98)00010-X_BIB3) 1993; 14 Siebler (10.1016/S0929-8266(98)00010-X_BIB20) 1995; 26 Spencer (10.1016/S0929-8266(98)00010-X_BIB22) 1990; 21 |
References_xml | – volume: 116 start-page: 1005 year: 1993 end-page: 1015 ident: BIB19 article-title: Silent cerebral embolism caused by neurologically symptomatic high-grade carotid stenosis publication-title: Brain contributor: fullname: Siebler – volume: 21 start-page: 415 year: 1990 end-page: 423 ident: BIB22 article-title: Detection of middle cerebral artery emboli during carotid endarterectomy using transcranial Doppler ultrasonography publication-title: Stroke contributor: fullname: Spencer – volume: 26 start-page: 2184 year: 1995 end-page: 2186 ident: BIB20 article-title: Cerebral microembolism and the risk of ischemia in asymptomatic high-grade internal carotid artery stenosis publication-title: Stroke contributor: fullname: Siebler – volume: 26 start-page: 1123 year: 1995 ident: BIB5 article-title: Basic identification criteria of Doppler microembolic signals publication-title: Stroke – volume: 4 start-page: 152 year: 1994 end-page: 156 ident: BIB6 article-title: The effect of different settings of ultrasound pulse amplitude, gain and sample volume on the appearance of emboli studied in a transcranial Doppler model publication-title: Cerebrovasc Dis contributor: fullname: Droste – volume: 18 start-page: 25 year: 1996 end-page: 30 ident: BIB7 article-title: Variability in occurrence of embolic signals in long term transcranial Doppler recordings publication-title: Neurol Res contributor: fullname: Droste – volume: 25 start-page: 382 year: 1994 end-page: 384 ident: BIB12 article-title: Doppler emboli signals vary according to stroke subtype publication-title: Stroke contributor: fullname: Grosset – start-page: 52 year: 1992 end-page: 58 ident: BIB18 article-title: The detection of cerebral emboli using Doppler ultrasound publication-title: Transcranial Doppler contributor: fullname: Russell – volume: 25 start-page: 1570 year: 1994 end-page: 1573 ident: BIB1 article-title: Clinical correlates of high-intensity transient signals detected on transcranial Doppler sonography in patients with cerebrovascular disease publication-title: Stroke contributor: fullname: Babikian – volume: 24 start-page: 1667 year: 1993 end-page: 1672 ident: BIB14 article-title: Computerized detection of cerebral emboli and discrimination from artifact using Doppler ultrasound publication-title: Stroke contributor: fullname: Markus – volume: 28 start-page: 2453 year: 1997 end-page: 2456 ident: BIB9 article-title: Oxygen inhalation can differentiate gaseous from non-gaseous microemboli detected by transcranial Doppler ultrasound publication-title: Stroke contributor: fullname: Droste – volume: 118 start-page: 1005 year: 1995 end-page: 1011 ident: BIB17 article-title: Asymptomatic cerebral embolic signals in symptomatic and asymptomatic carotid artery disease publication-title: Brain contributor: fullname: Markus – volume: 15 start-page: 253 year: 1994 end-page: 258 ident: BIB4 article-title: Automated detection of microemboli in transcranial Doppler signals publication-title: Ultraschall Med contributor: fullname: Casty – volume: 27 start-page: 1249 year: 1996 end-page: 1252 ident: BIB15 article-title: How good is intercenter agreement in the identification of embolic signals in carotid artery disease? 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publication-title: Stroke doi: 10.1161/01.STR.27.7.1249 contributor: fullname: Markus – volume: 23 start-page: 1652 year: 1992 ident: 10.1016/S0929-8266(98)00010-X_BIB21 article-title: Detection of intracranial emboli in patients with symptomatic extracranial carotid artery disease publication-title: Stroke doi: 10.1161/01.STR.23.11.1652 contributor: fullname: Siebler – volume: 118 start-page: 1005 year: 1995 ident: 10.1016/S0929-8266(98)00010-X_BIB17 article-title: Asymptomatic cerebral embolic signals in symptomatic and asymptomatic carotid artery disease publication-title: Brain doi: 10.1093/brain/118.4.1005 contributor: fullname: Markus – volume: 28 start-page: 2453 year: 1997 ident: 10.1016/S0929-8266(98)00010-X_BIB9 article-title: Oxygen inhalation can differentiate gaseous from non-gaseous microemboli detected by transcranial Doppler ultrasound publication-title: Stroke doi: 10.1161/01.STR.28.12.2453 contributor: fullname: Droste – start-page: 52 year: 1992 ident: 10.1016/S0929-8266(98)00010-X_BIB18 article-title: The detection of cerebral emboli using Doppler ultrasound contributor: fullname: Russell – volume: 14 start-page: 381 year: 1993 ident: 10.1016/S0929-8266(98)00010-X_BIB3 article-title: Digital audio tape as a method of storing Doppler ultrasound signals publication-title: Physiol Meas doi: 10.1088/0967-3334/14/3/017 contributor: fullname: Bush – volume: 18 start-page: 25 year: 1996 ident: 10.1016/S0929-8266(98)00010-X_BIB7 article-title: Variability in occurrence of embolic signals in long term transcranial Doppler recordings publication-title: Neurol Res doi: 10.1080/01616412.1996.11740372 contributor: fullname: Droste – volume: 21 start-page: 415 year: 1990 ident: 10.1016/S0929-8266(98)00010-X_BIB22 article-title: Detection of middle cerebral artery emboli during carotid endarterectomy using transcranial Doppler ultrasonography publication-title: Stroke doi: 10.1161/01.STR.21.3.415 contributor: fullname: Spencer – volume: 25 start-page: 382 year: 1994 ident: 10.1016/S0929-8266(98)00010-X_BIB12 article-title: Doppler emboli signals vary according to stroke subtype publication-title: Stroke doi: 10.1161/01.STR.25.2.382 contributor: fullname: Grosset – volume: 26 start-page: 2184 year: 1995 ident: 10.1016/S0929-8266(98)00010-X_BIB20 article-title: Cerebral microembolism and the risk of ischemia in asymptomatic high-grade internal carotid artery stenosis publication-title: Stroke doi: 10.1161/01.STR.26.11.2184 contributor: fullname: Siebler – volume: 4 start-page: 152 year: 1994 ident: 10.1016/S0929-8266(98)00010-X_BIB6 article-title: The effect of different settings of ultrasound pulse amplitude, gain and sample volume on the appearance of emboli studied in a transcranial Doppler model publication-title: Cerebrovasc Dis doi: 10.1159/000108472 contributor: fullname: Droste – volume: 28 start-page: 588 year: 1997 ident: 10.1016/S0929-8266(98)00010-X_BIB8 article-title: Bigated transcranial Doppler for the detection of clinically silent circulating emboli in normal persons and patients with prosthetic cardiac valves publication-title: Stroke doi: 10.1161/01.STR.28.3.588 contributor: fullname: Droste – volume: 15 start-page: 253 year: 1994 ident: 10.1016/S0929-8266(98)00010-X_BIB4 article-title: Automated detection of microemboli in transcranial Doppler signals publication-title: Ultraschall Med doi: 10.1055/s-2007-1004022 contributor: fullname: Casty |
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SubjectTerms | Carotid Stenosis - diagnostic imaging Cerebrovascular Disorders - diagnostic imaging Heart Valve Prosthesis - adverse effects High intensity transient signals Humans Intracranial Embolism and Thrombosis - diagnostic imaging Prosthetic cardiac values Sensitivity and Specificity Signal Processing, Computer-Assisted Stroke Transcranial Doppler Ultrasonography, Doppler, Transcranial |
Title | Detection of high intensity transient signals (HITS): How and why? |
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