{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T11:19:06Z","timestamp":1778671146774,"version":"3.51.4"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,11,13]],"date-time":"2019-11-13T00:00:00Z","timestamp":1573603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["R25NS079211"],"award-info":[{"award-number":["R25NS079211"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neuroimaging"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>BACKGROUND AND PURPOSE<\/jats:title><jats:p>Transcranial Doppler (TCD) criteria for cerebrovascular stenosis are only based on velocity with unsatisfactory positive predictive value (PPV) in previous studies. We refined a published scoring system that integrates several characteristics of TCD data in diagnosing middle cerebral artery (MCA) stenosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Using the TCD\u2010digital subtraction angiography (DSA) database from Stroke Outcomes and Neuroimaging of Intracranial Atherosclerosis (SONIA) trial, velocity, spectrum pattern, diffuse ratio, and asymmetry ratio were assessed. The cutpoints were defined for each parameter and a point value was assigned to each category within that parameter. A summed score was calculated for each MCA. The accuracy was assessed for different cutpoints in predicting \u226550% MCA stenosis measured by DSA. Logistic regression and C\u2010statistics were used for analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>A total of 114 MCAs were included in vessel\u2010based and 87 patients were included in patient\u2010based analysis. Compared to the velocity\u2010only cutpoints in SONIA, the score results in much improved PPV while negative predictive value (NPV) remains unchanged. The score based on mean velocity (score 0: &lt;140\u00a0cm\/s, score 3: \u2265140\u00a0cm\/s), spectrum pattern (score 0: no turbulence; score 1: mild turbulence; 2: significant turbulence), and asymmetry ratio (score 0: ratio\u00a0&lt;1.5, score 1: ratio 1.5\u20102; score 2: ratio \u22652.1) has the highest NPV while PPV remains favorable (PPV: 72% [95% CI 54\u201090%]; NPV: 84% [95% CI: 75\u201093%], area under curve [AUC]: .76 [95% CI: .66\u2010.86]).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The multiparameter scoring system incorporating several characteristics of TCD measures yielded higher PPV while maintaining high NPV compared with the single\u2010parameter velocity criteria in diagnosing MCA \u226550% stenosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jon.12678","type":"journal-article","created":{"date-parts":[[2019,11,13]],"date-time":"2019-11-13T12:37:57Z","timestamp":1573648677000},"page":"97-103","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A New Transcranial Doppler Scoring System for Evaluating Middle Cerebral Artery Stenosis"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1097-893X","authenticated-orcid":false,"given":"Qing","family":"Hao","sequence":"first","affiliation":[{"name":"Department of Neurology Icahn School of Medicine at Mount Sinai  New York NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"Feldmann","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Massachusetts School of Medicine\u2010Baystate  MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clotilde","family":"Balucani","sequence":"additional","affiliation":[{"name":"Department of Neurology The Johns Hopkins University  Baltimore MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Zubizarreta","sequence":"additional","affiliation":[{"name":"Institute for Healthcare Delivery Science, Department of Population Health Science and Policy Icahn School of Medicine at Mount Sinai  New York NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaobo","family":"Zhong","sequence":"additional","affiliation":[{"name":"Institute for Healthcare Delivery Science, Department of Population Health Science and Policy Icahn School of Medicine at Mount Sinai  New York NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven R.","family":"Levine","sequence":"additional","affiliation":[{"name":"Department of Neurology and Emergency Medicine, State University of New York Downstate Health Sciences University, and Department of Neurology Kings County Hospital Center  Brooklyn NY"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,11,13]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-4949.2006.00045.x"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.26.1.14"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.30.8.1604"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nec.2009.10.010"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6569.2002.tb00083.x"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jon199334242"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6569.2002.tb00123.x"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6569.2004.tb00256.x"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6569.2009.00412.x"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.1999.tb00660.x"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1159\/000073971"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6569.2002.tb00083.x"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043033"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6569.2008.00337.x"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1159\/000068744"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043033"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.4103\/0972-2327.112460"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0051862"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.01.025"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.109.555169"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000003837"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.118.313400"}],"container-title":["Journal 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