Transcranial Color-Coded Sonography With Angle Correction As a Screening Tool for Raised Intracranial Pressure Article Swipe
Venkatakrishna Rajajee
,
S. M. Reza Soroushmehr
,
Craig A. Williamson
,
Kayvan Najarian
,
Kevin R. Ward
,
Mohamad Hakam Tiba
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1097/cce.0000000000000953
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1097/cce.0000000000000953
OBJECTIVES: Transcranial Doppler (TCD) has been evaluated as a noninvasive intracranial pressure (ICP) assessment tool. Correction for insonation angle, a potential source of error, with transcranial color-coded sonography (TCCS) has not previously been reported while evaluating ICP with TCD. Our objective was to study the accuracy of TCCS for detection of ICP elevation, with and without the use of angle correction. DESIGN: Prospective study of diagnostic accuracy. SETTING: Academic neurocritical care unit. PATIENTS: Consecutive adults with invasive ICP monitors. INTERVENTIONS: Ultrasound assessment with TCCS. MEASUREMENTS AND MAIN RESULTS: End-diastolic velocity (EDV), time-averaged peak velocity (TAPV), and pulsatility index (PI) were measured in the bilateral middle cerebral arteries with and without angle correction. Concomitant mean arterial pressure (MAP) and ICP were recorded. Estimated cerebral perfusion pressure (CPP) was calculated as estimated CPP (CPPe) = MAP × (EDV/TAPV) + 14, and estimated ICP (ICPe) = MAP–CPPe. Sixty patients were enrolled and 55 underwent TCCS. Receiver operating characteristic curve analysis of ICPe for detection of invasive ICP greater than 22 mm Hg revealed area under the curve (AUC) 0.51 (0.37–0.64) without angle correction and 0.73 (0.58–0.84) with angle correction. The optimal threshold without angle correction was ICPe greater than 18 mm Hg with sensitivity 71% (29–96%) and specificity 28% (16–43%). With angle correction, the optimal threshold was ICPe greater than 21 mm Hg with sensitivity 100% (54–100%) and specificity 30% (17–46%). The AUC for PI was 0.61 (0.47–0.74) without angle correction and 0.70 (0.55–0.92) with angle correction. CONCLUSIONS: Angle correction improved the accuracy of TCCS for detection of elevated ICP. Sensitivity was high, as appropriate for a screening tool, but specificity remained low.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1097/cce.0000000000000953
- OA Status
- gold
- Cited By
- 6
- References
- 28
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4386156811
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4386156811Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1097/cce.0000000000000953Digital Object Identifier
- Title
-
Transcranial Color-Coded Sonography With Angle Correction As a Screening Tool for Raised Intracranial PressureWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-08-25Full publication date if available
- Authors
-
Venkatakrishna Rajajee, S. M. Reza Soroushmehr, Craig A. Williamson, Kayvan Najarian, Kevin R. Ward, Mohamad Hakam TibaList of authors in order
- Landing page
-
https://doi.org/10.1097/cce.0000000000000953Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
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https://doi.org/10.1097/cce.0000000000000953Direct OA link when available
- Concepts
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Medicine, Intracranial pressure, Receiver operating characteristic, Nuclear medicine, Cerebral perfusion pressure, Ultrasound, Area under the curve, Transcranial Doppler, Midline shift, Perfusion, Cardiology, Internal medicine, Radiology, HematomaTop concepts (fields/topics) attached by OpenAlex
- Cited by
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6Total citation count in OpenAlex
- Citations by year (recent)
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2025: 3, 2024: 2, 2023: 1Per-year citation counts (last 5 years)
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28Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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