Comparison of Vertebral Artery and Middle Cerebral Artery Monitoring for Right-to-left Shunt Detection by Contrast-enhanced Transcranial Doppler

• Published in: Scientific reports Vol. 6; no. 1; p. 24932
• Main Authors: Guo, Yu-Zhu, Gao, Yong-Sheng, Guo, Zhen-Ni, Niu, Peng-Peng, Yang, Yi, Xing, Ying-qi
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 21.04.2016; Nature Publishing Group
• Subjects: 631/378; 692/617; Adult; Carotid arteries; Carotid artery; Contrast Media; Female; Humanities and Social Sciences; Humans; Image Enhancement; Male; Middle Aged; Middle Cerebral Artery - physiology; Monitoring; multidisciplinary; Patients; Regional Blood Flow; Science; Stenosis; Stroke; Temporal bone; Ultrasonography, Doppler, Transcranial - methods; Ultrasound; Veins & arteries; Vertebrae; Vertebral Artery - physiology
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/srep24932

Contrast-enhanced transcranial Doppler (c-TCD) is a reliable and reproducible method for right-to-left shunt (RLS) detection, with high sensitivity. Monitoring the middle cerebral artery (MCA) is an optimal choice, yet for patients with insufficient temporal bone windows or severe stenosis of carotid arteries, an alternative should be established. The aim of the present study was to further establish whether c-TCD with vertebral artery (VA) monitoring is as effective as MCA monitoring for RLS detection. We evaluated 194 subjects for RLS detection with VA and MCA monitoring simultaneously. There was no significant difference between the positive rates of VA and MCA monitoring for RLS detection. c-TCD with VA monitoring could be an alternative for RLS detection, with high sensitivity and specificity both at rest and during the Valsalva manoeuvre.