Body Positions in the Diagnosis of Right-to-Left Shunt by Contrast Transcranial Doppler

Han, Ke; Xing, Yingqi; Yang, Yi; Chao, A-Ching; Sheng, Wen‐Yung; Hu, Han‐Hwa; Wu, Jiang

doi:10.1016/j.ultrasmedbio.2015.04.023

Cited by 3 publications

(1 citation statement)

References 23 publications

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“…The criterion of a “valid procedure” is that the spectrum of the M-mode remains stable. Secondly, the right lateral decubitus was not the optimal position for RLS detection, due to the anatomic location of the right atrium and patent foreman ovale, which may have affected the performance of the standard VM 18 19 20 21 . However, MCA and VA monitoring were performed simultaneously in the same position, even if the positive rate of RLS detection may be a little lower than that in other positions; however, the comparison between MCA and VA monitoring was not affected.…”

Section: Discussionmentioning

confidence: 99%

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

Guo

Gao

Guo

et al. 2016

Sci Rep

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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.

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Section: Discussionmentioning

confidence: 99%

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

Guo

Gao

Guo

et al. 2016

Sci Rep

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Transorbital Doppler with carotid siphon monitoring detects right-to-left shunt effectively

Duan

Yang

Song

et al. 2018

Neurological Research

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Background Transtemporal Doppler (TTD) with middle cerebral artery (MCA) is widely used for right-to-left shunt (RLS) detection. However, an alternative method for patients without suitable temporal bone windows should be established. The present study prospectively evaluated the effectiveness of transorbital Doppler (TOD) with carotid siphon (CS) monitoring in detecting RLS. Methods A total of 357 subjects with sufficient temporal bone windows underwent simultaneous TTD with MCA and TOD with CS. After injection of microbubbles, the numbers of artificial high-intensity signals were recorded at rest and after Valsalva maneuver. Results TOD with CS detected RLS in 146 patients. Sensitivity was 97.1%, specificity 95%, positive predictive value 92.5%, and negative predictive value 98.1%. The total positive rates for RLS detection by CS (40.9%) and MCA (37.8%) monitoring were comparable without significant difference, but TOD with CS detected significantly more grade 2 and 3 RLS than TTD with MCA (p = 0.001). The RLS rates of cryptogenic stroke patients was significantly higher than that of healthy controls, and RLS in cryptogenic stroke was remarkably higher than that in transient ischemia attack patients (p < 0.05). TOD with CS examined significantly more grade 2 and 3 RLSs than the MCA approach in the cryptogenic stroke patients (p = 0.037). Conclusion TOD with CS monitoring is able to detect RLS effectively in different populations including healthy subjects, cryptogenic stroke, transient ischemia attack, and migraine patients. In comparing to the TTD with MCA approach, TOD with CS monitoring could detect comparable rate of RLS, but more high grades of RLS.

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Comparison of the Right-to-left Shunt Test by Transcranial Doppler Based on the Addition of Blood and Patient Posture

KANG,

LEE,

LEE

et al. 2024

Korean J Clin Lab Sci

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Body Positions in the Diagnosis of Right-to-Left Shunt by Contrast Transcranial Doppler

Cited by 3 publications

References 23 publications

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

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

Transorbital Doppler with carotid siphon monitoring detects right-to-left shunt effectively

Comparison of the Right-to-left Shunt Test by Transcranial Doppler Based on the Addition of Blood and Patient Posture

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