The diagnostic performance of transcranial Doppler ultrasound and carotid duplex in the diagnosis of cerebral small vessel disease

Abstract

Background and rationale: Cerebral small vessel disease is a frequent, long-term, and progressing vascular disease accounting for twenty percent of whole strokes and twenty-five percent of ischemic strokes. Forty-four individuals participated in this study distributed into twenty-two cases with cerebral small vessel disease and twenty-two control subjects. The study aimed to assess the diagnostic performance of the carotid duplex and transcranial Doppler ultrasound in the screening, detection, and severity of cerebral small vessel disease. Results: The correlation among the pulsatility index of the common carotid artery, internal cerebral artery, middle cerebral artery, and cerebral small vessel disease showed a statistical significance with p-values < 0.001, 0.003, and < 0.001, respectively. Transcranial Doppler ultrasound showed mean resistive index and pulsatility index of the middle cerebral artery had high specificity (81.8%, 81.8%, respectively) and sensitivity (68.2% and 86.4%, respectively) in predicting cerebral small vessel disease with cutoff value (0.595 and 0.9525, respectively). Conclusion: The middle cerebral artery resistive index and pulsatility index are significantly correlated with cerebral small vessel disease. Moreover, there is a significant relation among cerebral large artery stiffness and cerebral small vessel disease burden. Transcranial Doppler ultrasound and carotid duplex can be considered an effective physiological indicator for the determination of cerebral small vessel disease with their advantages of being safe, affordable, noninvasive, and radiation-free screening tools.