{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T04:42:33Z","timestamp":1771562553877,"version":"3.50.1"},"reference-count":13,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2006,10,6]],"date-time":"2006-10-06T00:00:00Z","timestamp":1160092800000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Neuroimaging"],"published-print":{"date-parts":[[2006,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p> <jats:italic>Background.<\/jats:italic> Stringent transcranial Doppler (TCD) criteria for diagnosing occlusion are needed for more reliable TCD performance at bedside in the acute stroke setting.<\/jats:p><jats:p> <jats:italic>Subjects and Methods.<\/jats:italic> At three academic stroke centers, we performed TCD examination for patients with symptoms of cerebral ischemia who underwent digital subtraction angiography (DSA). We used a standard insonation protocol with power M\u2010mode Doppler (PMD) TCD (TCD 100M, Spencer Technologies Inc., Seattle, WA). We collected mean flow velocity (MFV), pulsatility indices (PI), and power M\u2010mode resistance signature (absent, high, or low) in symptomatic middle (MCA), anterior (ACA), posterior (PCA), and in affected (a), ipsilateral (i), and contralateral (c\u2010lat) cerebral arteries. Ratios of aMCA\/c\u2010lat MCA, aMCA\/iACA, and aMCA\/iPCA MFV were subsequently calculated. PMD\u2010TCD flow findings were evaluated with a receiver\u2010operating characteristic (ROC) analysis for angiographically proven MCA occlusion.<\/jats:p><jats:p> <jats:italic>Results.<\/jats:italic> We studied 120 patients with acute cerebral ischemia with PMD\u2010TCD examinations prior to or immediately after DSA. Lower aMCA velocities pointed to higher probability of occlusion (<jats:italic>P<\/jats:italic>= .055). The aMCA\/iPCA MFV ratio was superior to the aMCA\/iACA ratio and strongly predictive of occlusion at a threshold ratio of 0.5 (RR 2.31 CI<jats:sub>95<\/jats:sub> 2.13\u20102.51). High resistance or absent M\u2010mode flow signatures in the proximal MCA were present in 87% of M1 and M2 MCA occlusions (probability 87%). In the presence of a low\u2010resistance PMD signature, obtaining the aMCA\/iPCA MFV ratio &lt;0.5 increases probability of occlusion to 87%. Normal MFV ratios and low\u2010resistance M\u2010mode signatures are highly predictive of a negative angiogram for MCA occlusion.<\/jats:p><jats:p> <jats:italic>Conclusion.<\/jats:italic> In acute cerebral ischemia, reliable criteria for proximal MCA occlusion have been developed based on combination of MFV ratios and M\u2010mode flow resistance signatures. Validation of these criteria will require multicenter studies.<\/jats:p>","DOI":"10.1111\/j.1552-6569.2006.00055.x","type":"journal-article","created":{"date-parts":[[2009,10,5]],"date-time":"2009-10-05T14:02:39Z","timestamp":1254751359000},"page":"323-328","source":"Crossref","is-referenced-by-count":20,"title":["Derivation of Power M\u2010Mode Transcranial Doppler Criteria for Angiographic Proven MCA Occlusion"],"prefix":"10.1111","volume":"16","author":[{"given":"Maher","family":"Saqqur","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael D.","family":"Hill","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrei V.","family":"Alexandrov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jayanta","family":"Roy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcia","family":"Schebel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Krol","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zsolt","family":"Garami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashfaq","family":"Shuaib","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew M.","family":"Demchuk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2006,10,6]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199512143332401"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199710303371812"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.20.7.899"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/jon199334242"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.28.1.133"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/jon20001011"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-5629(01)00486-0"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6569.2002.tb00127.x"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.30.8.1604"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1995.82.6.0972"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.32.1.89"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.21.4.532"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-5629(97)00077-X"}],"container-title":["Journal of Neuroimaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1552-6569.2006.00055.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1552-6569.2006.00055.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T02:27:57Z","timestamp":1696991277000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1552-6569.2006.00055.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,10]]},"references-count":13,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2006,10]]}},"alternative-id":["10.1111\/j.1552-6569.2006.00055.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1552-6569.2006.00055.x","archive":["Portico"],"relation":{},"ISSN":["1051-2284","1552-6569"],"issn-type":[{"value":"1051-2284","type":"print"},{"value":"1552-6569","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,10]]}}}