Journal of neuroimaging : official journal of the American Society of Neuroimaging
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The purpose of this study was to reevaluate the usefulness of relative maximum signal drop (rMSD), as compared to relative cerebral blood volume (rCBV) and cerebral blood flow (rCBF), in dynamic susceptibility contrast magnetic resonance imaging (MRI). ⋯ The authors conclude that rMSD is as useful as rCBF under a variety of pathophysiological conditions, whereas in conditions with normal mean transit time, such as brain tumors, rMSD provides equivalent blood volume information to rCBV. The simplicity of rMSD maps could lead to the increased use of perfusion-weighted MRI.
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Power motion mode Doppler (PMD) simultaneously displays flow signal intensity and direction over several centimeters of intracranial space. Insonation protocol for PMD and spectral transcranial Doppler (TCD) with typical PMD flow signatures is described in serial patients with acute stroke symptoms examined via conventional windows with a PMD/TCD unit. ⋯ PMD is a window-finding tool and a guide for spectral TCD gate placement. PMD facilitates flow detection in the M2 branches and the distal basilar artery. PMD can demonstrate recanalization of the entire MCA main stem and proximal branches, increase the yield of embolus detection and procedure monitoring, and facilitate abnormal flow pattern recognition.
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Duplex scanning is an accepted method for noninvasive evaluation of carotid stenosis. However, the ultrasound criteria used for the detection of threshold stenoses vary widely between laboratories, and quality assurance measures to allow adjustment of criteria are often lacking. This study was completed using receiver operating characteristic (ROC) analysis to determine Doppler velocity criteria for threshold carotid stenoses, compared to an accepted standard, and to demonstrate methods to allow adjustment of criteria. ⋯ This study showed that duplex scanning is able to detect threshold carotid stenoses. For the best performance, each laboratory should have its own criteria; however, the criteria provided here could be a helpful reference to those laboratories that have not yet established their own criteria. Most important, this study provides an example of how to evaluate the performance criteria, how to modify them, how such changes can affect performance, and how performance can be modified depending on the goals of the laboratory.