Dive into the latest advancements in understanding cerebrovascular reactivity through Transcranial Doppler, a pivotal tool in diagnosing and managing cerebrovascular disease, and discover the critical thresholds that are reshaping clinical practices.
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Transcranial Doppler cerebrovascular reactivity: Thresholds for clinical significance in cerebrovascular disease.
Regenhardt et al., J Neuroimaging 2024
<!– DOI: 10.1111/jon.13197 //–>
https://doi.org/10.1111/jon.13197
This study establishes clinically significant thresholds for carbon dioxide reactivity (CO2R) and vasomotor range (VMR) in cerebrovascular reactivity (CVR) studies for patients with cerebral arterial stenosis. Conducted on 62 patients, the research determined that an abnormal CO2R is <0.80% and an abnormal VMR is <7.9%. These thresholds were derived from the unaffected side of patients with unilateral stenosis and validated against various diagnostic measures including acetazolamide single-photon emission computed tomography (SPECT), CT/MRI perfusion, and MRI infarction. The CO2R threshold showed a sensitivity (Sn) of 0.73 and specificity (Sp) of 0.79 for predicting abnormal acetazolamide SPECT, while the VMR threshold had a Sn of 0.46 and Sp of 0.94 for the same measure. These findings suggest that noninvasive CVR testing, using these thresholds, could be valuable in diagnosing and risk stratifying patients with stenosis, especially considering the common comorbidities of hypertension, diabetes, stroke, and smoking within this population.